[Autologous versus allogeneic stem cell transplantation in adult patients with acute lymphoblastic leukemia].
OBJECTIVE
To explore the efficacy of autologous or allogeneic stem cell transplantation in adult patients with acute lymphoblastic leukemia (ALL) and investigate its relevant prognostic factors.


METHODS
A total of 96 adult patients with ALL who had admitted to our hospital from November 1986 to June 2004 were followed up till February 28, 2005. They were divided into autologous stem cell transplantation (Auto-SCT) group (n = 56) and allogeneic stem cell transplantation (Allo-SCT) group (n = 40). Auto-SCT group was further divided to treated subgroup, in which patients received graft-purified transplantation and (or) maintenance immunotherapy or chemotherapy after transplantation (n = 26), and non-treated subgroup (n = 30). Clinical characteristics of these groups were retrospectively analyzed. Survival date were analyzed by the Kaplan-Meier method and the prognostic factors were analyzed with the COX regression model.


RESULTS
The 1-, 3-, and 5-year leukemia-free-survival (LFS) were not significantly different between the auto-SCT group and the allo-SCT group. The 3-and 5-year LFS of auto-SCT treated subgroup, auto-SCT non-treated subgroup and allo-SCT group were [(73.0 +/- 8.7)%, (69.2 +/- 9.0)%], [(42.2 +/- 10.1)%, (35.1 +/- 10.0)%], and [(50.9 +/- 8.2)%, (50.9 +/- 8.2)%], respectively, which showed statistical significance (P < 0.05).


CONCLUSIONS
The long-term LFS is similar after auto-SCT and after allo-SCT. Purified graft and maintain immunotherapy or chemotherapy post-transplantation may decrease the relapse rate after auto-SCT and improve survival.
Wang
Guo-Rong
GR
Center of Haematopoietic Stem Cell Transplantation, Blood Diseases Hospital, CAMS and PUMC, Tianjin 300020, China.
Xu
Yan
Y
Zou
De-Hui
DH
Zhao
Yao-Zhong
YZ
Wang
Mei
M
Han
Ming-Zhe
MZ
Feng
Si-Zhou
SZ
Yan
Wen-Wei
WW
Qiu
Lu-Gui
LG
D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000601:surgery*; D012189:Retrospective Studies; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous