title: An auto-SCT-based total therapy resulted in encouraging outcomes in adolescents and young adults with acute lymphoblastic leukemia: report from a single center of China.
abstract: Application of auto-SCT in the post-remission therapy for adolescents and young adults (AYAs) with ALL is controversial. We analyzed the outcomes of 79 AYAs (15-24 years) with ALL who received our designed total therapy protocol with auto-SCT in first CR from 1990 to 2009. The estimated OS and EFS at 5 years for the cohort were 62.8±5.9 and 61.5±5.7%. The cumulative non-relapse mortality and relapse rate at 5 years for the cohort were 7.2±3.1 and 33.6±5.8%. Time to CR >4 weeks was the only independent unfavorable factor associated with OS, EFS and relapse in multivariate analysis. Patients in standard risk (SR) group and high risk (HR) group had better OS (78.3±7.4, 63.8±10.2 vs 38.1±11.6%) and EFS (78.0±7.4, 63.4±9.4 vs 32.4±11.3%), and lower relapse rate (15.9±6.5, 31.5±9.5 vs 65.7±11.8%) compared with patients in very high risk (VHR) group. Our data confirmed that auto-SCT-based total therapy might be an optional treatment strategy for AYAs with ALL in SR. Patients in HR also could get benefit from such schedule. But for those in VHR, allogenetic SCT is still the prior recommendation for the frequent recurrence after auto-SCT.
authors.affiliation: State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, PR China.
authors.forename: J
authors.initials: J
authors.lastname: Huang
authors.forename: D-H
authors.initials: DH
authors.lastname: Zou
authors.forename: Z-J
authors.initials: ZJ
authors.lastname: Li
authors.forename: M-W
authors.initials: MW
authors.lastname: Fu
authors.forename: Y
authors.initials: Y
authors.lastname: Xu
authors.forename: Y-Z
authors.initials: YZ
authors.lastname: Zhao
authors.forename: J-Y
authors.initials: JY
authors.lastname: Qi
authors.forename: S-Z
authors.initials: SZ
authors.lastname: Feng
authors.forename: B-C
authors.initials: BC
authors.lastname: Liu
authors.forename: D
authors.initials: D
authors.lastname: Lin
authors.forename: Y-C
authors.initials: YC
authors.lastname: Mi
authors.forename: M-Z
authors.initials: MZ
authors.lastname: Han
authors.forename: J-X
authors.initials: JX
authors.lastname: Wang
authors.forename: L-G
authors.initials: LG
authors.lastname: Qiu
mesh_terms: D000293:Adolescent; D002681:China / Q000453:epidemiology; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000401:mortality* / Q000628:therapy*; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D033581:Stem Cell Transplantation; D015996:Survival Rate; D014182:Transplantation, Autologous; D055815:Young Adult