Allogeneic stem cell transplantation for adult Philadelphia chromosome-negative acute lymphocytic leukemia: comparable survival rates but different risk factors between related and unrelated transplantation in first complete remission.
To identify factors to improve the outcomes of related and unrelated allogeneic stem cell transplantations (allo-SCT) for Philadelphia chromosome-negative acute lymphocytic leukemia (Ph(-) ALL) in the first complete remission (CR1), we retrospectively analyzed 1139 Ph(-) ALL patients using the registry data, particularly the details of 641 patients transplanted in CR1. Overall survival was significantly superior among patients transplanted in CR1, but no significant difference was observed between related and unrelated allo-SCTs (related vs unrelated: 65% vs 62% at 4 years, respectively; P = .19). Among patients transplanted in CR1, relapse rates were significantly higher in related allo-SCT compared with unrelated allo-SCT, and multivariate analysis demonstrated that less than 6 months from diagnosis to allo-SCT alone was associated with relapse. On the other hand, nonrelapse mortality (NRM) was significantly higher in unrelated allo-SCT compared with related allo-SCT, and multivariate analysis demonstrated that 10 months or longer from diagnosis to allo-SCT, human leukocyte antigen mismatch, and abnormal karyotype were associated with NRM. In conclusion, our study showed comparable survival rates but different relapse rates, NRM rates, and risk factors between related and unrelated allo-SCTs. After a close consideration of these factors, the outcome of allo-SCT for adult Ph(-) ALL in CR1 could be improved.
Nishiwaki
Satoshi
S
Department of Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan. n-3104@tf7.so-net.ne.jp
Inamoto
Yoshihiro
Y
Sakamaki
Hisashi
H
Kurokawa
Mineo
M
Iida
Hiroatsu
H
Ogawa
Hiroyasu
H
Fukuda
Takahiro
T
Ozawa
Yukiyasu
Y
Kobayashi
Naoki
N
Kasai
Masanobu
M
Mori
Takehiko
T
Iwato
Koji
K
Yoshida
Takashi
T
Onizuka
Makoto
M
Kawa
Keisei
K
Morishima
Yasuo
Y
Suzuki
Ritsuro
R
Atsuta
Yoshiko
Y
Miyamura
Koichi
K
D000293:Adolescent; D000328:Adult; D002423:Cause of Death; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D010677:Philadelphia Chromosome; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000401:mortality* / Q000628:therapy*; D012008:Recurrence; D012074:Remission Induction; D012307:Risk Factors; D033581:Stem Cell Transplantation; D015996:Survival Rate; D014019:Tissue Donors; D014184:Transplantation, Homologous; D055815:Young Adult