Transplantations in adult acute lymphoblastic leukemia--grounds for optimism?
The large MRC/ECOG Adult Acute Lymphoblastic Leukemia Study establishes the value of sibling donor allogeneic transplantation in patients with standard risk, demonstrating superior outcome to conventional chemotherapy. The small but significant number of patients having matched unrelated donor transplantations on this study protocol appear to do well and might establish the value of such an approach for those without a sibling. Reduced-intensity conditioning might begin to address the transplantation-related mortality problems of the older patients. The youngest adults might not need to undergo transplantation at all. If they are now treated on pediatric chemotherapy protocols, their outcome appears to improve significantly.
Goldstone
Anthony H
AH
Department of Haematology, University College London Hospitals, London NW1 2BU, United Kingdom. anthony.goldstone@uclh.nhs.uk
D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002648:Child; D002986:Clinical Trials as Topic; D006086:Graft vs Host Disease; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D008495:Medical Oncology / Q000379:methods* / Q000639:trends; D008875:Middle Aged; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000628:therapy*; D019172:Transplantation Conditioning / Q000379:methods; D014184:Transplantation, Homologous; D016896:Treatment Outcome
D000970:Antineoplastic Agents