title: Impact of transplant eligibility and availability of a human leukocyte antigen-identical matched related donor on outcome of older patients with acute lymphoblastic leukemia.
abstract: The role of allogeneic hematopoietic cell transplant (allo-HCT) in elderly patients with acute lymphoblastic leukemia (ALL) is unclear. We conducted a prospective study including 110 homogeneously treated patients with ALL aged 50-70 years. Their outcomes were analyzed by intention-to-treat on a donor-versus-no donor basis. Fifty-five patients (50%) underwent human leukocyte antigen (HLA) typing and were considered potential allo-HCT candidates, although only 25 (23%) eventually received an allo-HCT. Among potential allo-HCT candidates, patients with (n = 28) and without (n = 27) an HLA-identical sibling showed similar leukemia-free survival, overall survival (OS) and relapse risk, and the only variable associated with a better outcome was achievement of first complete remission (CR1) after induction therapy. Among the 25 patients who actually received an allo-HCT, the 4-year non-relapse mortality and OS were 42% (95% confidence interval 31-53%) and 37% (95% confidence interval 27-47%), respectively. In conclusion, having an HLA-identical sibling donor was not associated with a better outcome in patients with ALL aged 50-70 years.
authors: a Department of Hematology , Hospital Universitari Vall d'Hebron-Universitat Autònoma de Barcelona , Barcelona , Spain.
authors: Pere
authors: P
authors: Barba
authors: b Department of Hematology , Hospital de la Santa Creu i Sant Pau , Barcelona , Spain.
authors: Rodrigo
authors: R
authors: Martino
authors: c Department of Hematology , Hospital Universitario La Fe , Valencia , Spain.
authors: David
authors: D
authors: Martinez-Cuadron
authors: d Department of Hematology , ICO-Hospital Germans Trias i Pujol, Jose Carreras Research Institute , Badalona , Spain.
authors: García
authors: G
authors: Olga
authors: b Department of Hematology , Hospital de la Santa Creu i Sant Pau , Barcelona , Spain.
authors: Albert
authors: A
authors: Esquirol
authors: e Department of Hematology , Hospital General , Alicante , Spain.
authors: Cristina
authors: C
authors: Gil-Cortés
authors: f Department of Hematology , Hospital Virgen del Rocío , Sevilla , Spain.
authors: José
authors: J
authors: Gonzalez
authors: g Department of Hematology , Hospital Clínic , Barcelona , Spain.
authors: Francesc
authors: F
authors: Fernandez-Avilés
authors: a Department of Hematology , Hospital Universitari Vall d'Hebron-Universitat Autònoma de Barcelona , Barcelona , Spain.
authors: David
authors: D
authors: Valcárcel
authors: h Department of Hematology , Hospital Josep Trueta , Girona , Spain.
authors: Ramón
authors: R
authors: Guardia
authors: i Department of Hematology , Hospital Duran i Reynals, Hospitalet de Llobregat , Spain.
authors: Rafael F
authors: RF
authors: Duarte
authors: j Department of Hematology , IBSAL, IBMCC, Centro de Investigación del Cáncer, Universidad de Salamanca-CSIC and Hospital Universitario Salamanca , Salamanca , Spain.
authors: Jesús Maria
authors: JM
authors: Hernandez-Rivas
authors: k Department of Hematology , Hospital del Mar , Barcelona , Spain ; for the Programa Español de Tratamientos en Hematología (PETHEMA) group.
authors: Eugenia
authors: E
authors: Abella
authors: c Department of Hematology , Hospital Universitario La Fe , Valencia , Spain.
authors: Pau
authors: P
authors: Montesinos
authors: d Department of Hematology , ICO-Hospital Germans Trias i Pujol, Jose Carreras Research Institute , Badalona , Spain.
authors: Josep Maria
authors: JM
authors: Ribera
mesh_terms: D000367:Age Factors; D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D006680:HLA Antigens / Q000235:genetics / Q000276:immunology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods; D006648:Histocompatibility; D006650:Histocompatibility Testing; D006801:Humans; D008297:Male; D008875:Middle Aged; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D012008:Recurrence; D019233:Retreatment; D012307:Risk Factors; D035781:Siblings; D014019:Tissue Donors; D014184:Transplantation, Homologous; D016896:Treatment Outcome
chemical_list: D006680:HLA Antigens
keywords: Allogeneic transplant; HCT; RIC; acute lymphoblastic leukemia