Impact of a donor source on adult Philadelphia chromosome-negative acute lymphoblastic leukemia: a retrospective analysis from the Adult Acute Lymphoblastic Leukemia Working Group of the Japan Society for Hematopoietic Cell Transplantation.
BACKGROUND
We aimed to clarify the impact of the donor source of allogeneic stem cell transplantation (allo-SCT) on Philadelphia chromosome-negative acute lymphoblastic leukemia [Ph(-) ALL] with focus on cord blood (CB).


METHODS
We retrospectively analyzed data of 1726 patients who underwent myeloablative allo-SCT for adult Ph(-) ALL. The sources of the allo-SCT were related donors (RD; N = 684), unrelated donors (URD; N = 809), and CB (N = 233).


RESULTS
Overall survival (OS) in patients after CB allo-SCT in first complete remission (CR1) was comparable with that after RD or URD allo-SCT (RD: 65%, URD: 64% and CB: 57% at 4 years, P = 0.11). CB was not a significant risk factor for relapse or non-relapse mortality as well as for OS in multivariate analyses. Similarly, the donor source was not a significant risk factor for OS in subsequent CR or non-CR (RD: 47%, URD: 39% and CB: 48% in subsequent CR, P = 0.33; RD: 15%, URD: 21% and CB: 18% in non-CR, P = 0.20 at 4 years).


CONCLUSIONS
Allo-SCT using CB led to OS similar to those of RD or URD in any disease status. To avoid missing the appropriate timing, CB is a favorable alternative source for adult Ph(-) ALL patients without a suitable RD or URD.
Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan. mail:n-3104@tf7.so-net.ne.jp
S
S
Nishiwaki
K
K
Miyamura
K
K
Ohashi
M
M
Kurokawa
S
S
Taniguchi
T
T
Fukuda
K
K
Ikegame
S
S
Takahashi
T
T
Mori
K
K
Imai
H
H
Iida
M
M
Hidaka
H
H
Sakamaki
Y
Y
Morishima
K
K
Kato
R
R
Suzuki
J
J
Tanaka
D000293:Adolescent; D000328:Adult; D000368:Aged; D036101:Cord Blood Stem Cell Transplantation / Q000379:methods / Q000592:standards; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods* / Q000592:standards; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010677:Philadelphia Chromosome; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000453:epidemiology* / Q000235:genetics / Q000601:surgery*; D012189:Retrospective Studies; D012955:Societies, Medical / Q000592:standards*; D014019:Tissue Donors; D016896:Treatment Outcome; D055815:Young Adult
Philadelphia chromosome-negative acute lymphoblastic leukemia; allogeneic stem cell transplantation; cord blood; donor source