title: Nelarabine for T cell acute lymphoblastic leukemia relapsing after allogeneic hematopoietic stem cell transplantation: an opportunity to improve survival.
abstract: T-ALL relapsing after allogeneic stem cell transplantation is unusual but classically associated with poor outcome. Recently, encouraging results have been reported with Nelarabine in relapse or refractory cases. On behalf of the Group of Research in Adult ALL (GRAALL), we conducted a retrospective analysis of patients receiving Nelarabine following relapse after transplantation. Eleven patients received Nelarabine as salvage therapy in this situation. Most of them were transplanted in first Complete Remission (CR), and received a myeloablative conditioning regimen in 7 cases. Relapse occurred with a median time of 199 days. Nelarabine was given at 1.5 g/m(2)/day (Day 1, D3, D5) alone (N = 5) or in association (N = 6). The overall hematological response rate was 81%. Neurologic toxicity represents the main adverse event (N = 4), mainly grade I-II. Event free survival and overall survival at 1 year were 70 and 90% respectively. Nelarabine is a valuable option for salvage therapy in T-cell acute lymphoblastic leukemia relapsing after transplantation.
authors: Service d'Hématologie clinique et de Thérapie cellulaire, Bordeaux, Pessac, France. edouardforcade@yahoo.fr
authors: Edouard
authors: E
authors: Forcade
authors: Thibaut
authors: T
authors: Leguay
authors: Norbert
authors: N
authors: Vey
authors: André
authors: A
authors: Baruchel
authors: Jacques
authors: J
authors: Delaunay
authors: Marie
authors: M
authors: Robin
authors: Gérard
authors: G
authors: Socié
authors: Hervé
authors: H
authors: Dombret
authors: Régis
authors: R
authors: Peffault de Latour
authors: Emmanuel
authors: E
authors: Raffoux
mesh_terms: D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001087:Arabinonucleosides / Q000008:administration & dosage* / Q000009:adverse effects; D004334:Drug Administration Schedule; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D054218:Precursor T-Cell Lymphoblastic Leukemia-Lymphoma / Q000276:immunology / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000379:methods*; D016019:Survival Analysis; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous
chemical_list: D000970:Antineoplastic Agents; D001087:Arabinonucleosides; C104457:nelarabine