title: [Autologous hematopoietic stem cell transplantation as late high-dose consolidation in adult patients with T-cell lymphoblastic leukemias: Results of a Russian multicenter study].
abstract: OBJECTIVE
  To analyze the efficiency of the ALL-2009 protocol (ClinicalTrials.gov NCT01 193933) in patients with T-cell leukemias, particularly the role of autologous hematopoietic stem cell transplantation (auto-HSCT) after non-myeloablative BEAM conditioning, followed by maintenance therapy.
  
  
  METHODS
  Since 2009, the ALL-2009 study has enrolled 90 patients with T-cell acute lymphoblastic leukemia (T-ALL), the treatment results were assessed in 86 patients: 6 and 28 patients underwent allogeneic HSCT and auto-HSCT, respectively. A landmark analysis was used to compare survival rates in patients who had undergone auto-HSCT and in those who had not. For this, the median time from complete remission to the date of auto-HSCT was determined (the median was 6 months). Then to compare with the auto-HSCT group, only 27 patients who had been in complete remission for 6 months or more were included in a chemotherapy group.
  
  
  RESULTS
  The achievement of complete remission in patients with thymic T-ALL (100%) was significantly higher than in those with early (85.7%) or mature (70%) variants. The patients with early and mature T-ALL as compared to those with thymic T-ALL showed high death rates in the remission induction (7.4 and 10% versus 0) and the patients with mature T-ALL had a.higher proportion of refractory forms (20% versus 0). The 5-year overall and relapse-free survival rates in all the T-ALL patients were 66 and 76%, respectively. After auto-HSCT, the risk of recurrence was 0% versus 21% after chemotherapy (p=0.03). The relapse-free survival rates significantly differed in the auto-HSCT and non-auto-HSCT groups: 100 and 66%, respectively (p=0.047).
  
  
  CONCLUSIONS
  The long-term survival rates obtained during this multicenter study in the T-ALL patients treated according to the ALL-2009 protocol, the basis for which is the principle of continuity of cytostatic effects, are exclusively optimistic. Late consolidation with auto-HSCT following non-myeloablative BEAM conditioning, followed by maintenance therapy, considerably reduces the risk of recurrence.
authors.affiliation: Hematology Research Center, Ministry of Health of Russia, Moscow, Russia.
authors.forename: E N
authors.initials: EN
authors.lastname: Parovichnikova
authors.affiliation: Hematology Research Center, Ministry of Health of Russia, Moscow, Russia.
authors.forename: L A
authors.initials: LA
authors.lastname: Kuzmina
authors.affiliation: Hematology Research Center, Ministry of Health of Russia, Moscow, Russia.
authors.forename: L P
authors.initials: LP
authors.lastname: Mendeleeva
authors.affiliation: Hematology Research Center, Ministry of Health of Russia, Moscow, Russia.
authors.forename: G A
authors.initials: GA
authors.lastname: Klyasova
authors.affiliation: Hematology Research Center, Ministry of Health of Russia, Moscow, Russia.
authors.forename: V V
authors.initials: VV
authors.lastname: Troitskaya
authors.affiliation: Hematology Research Center, Ministry of Health of Russia, Moscow, Russia.
authors.forename: A N
authors.initials: AN
authors.lastname: Sokolov
authors.affiliation: Hematology Research Center, Ministry of Health of Russia, Moscow, Russia.
authors.forename: Z Kh
authors.initials: ZK
authors.lastname: Akhmerzaeva
authors.affiliation: Hematology Research Center, Ministry of Health of Russia, Moscow, Russia.
authors.forename: S K
authors.initials: SK
authors.lastname: Kravchenko
authors.affiliation: Hematology Research Center, Ministry of Health of Russia, Moscow, Russia.
authors.forename: E O
authors.initials: EO
authors.lastname: Gribanova
authors.affiliation: Hematology Research Center, Ministry of Health of Russia, Moscow, Russia.
authors.forename: E E
authors.initials: EE
authors.lastname: Zvonkov
authors.affiliation: Research Institute of Pediatric Hematology and Transplantology, I.P. Pavlov Saint Petersburg State Medical University, Ministry of Health of Russia, Saint Petersburg, Russia.
authors.forename: S N
authors.initials: SN
authors.lastname: Bondarenko
authors.affiliation: N.N. Blokhin Russian Cancer Research Center, Moscow, Russia.
authors.forename: O Yu
authors.initials: OY
authors.lastname: Baranova
authors.affiliation: Regional Clinical Hospital, Tula, Russia.
authors.forename: T V
authors.initials: TV
authors.lastname: Ryltsova
authors.affiliation: Regional Clinical Hospital, Saransk, Russia.
authors.forename: L V
authors.initials: LV
authors.lastname: Gavrilova
authors.affiliation: Regional Clinical Hospital, Surgut, Russia.
authors.forename: E E
authors.initials: EE
authors.lastname: Zinina
authors.affiliation: Regional Clinical Hospital, Ryazan, Russia.
authors.forename: A S
authors.initials: AS
authors.lastname: Pristupa
authors.affiliation: Regional Clinical Hospital, Irkutsk, Russia.
authors.forename: T S
authors.initials: TS
authors.lastname: Kaporskaya
authors.affiliation: Kirov Research Institute of Hematology and Blood Transfusion, Federal Biomedical Agency of Russia, Kirov, Russia.
authors.forename: N V
authors.initials: NV
authors.lastname: Minaeva
authors.affiliation: Regional Clinical Hospital, Nizhny Novgorod, Russia.
authors.forename: O S
authors.initials: OS
authors.lastname: Samoilova
authors.affiliation: Regional Clinical Hospital, Yekaterinburg, Russia.
authors.forename: T S
authors.initials: TS
authors.lastname: Konstantinova
authors.affiliation: Regional Clinical Hospital, Yaroslavl, Russia.
authors.forename: V A
authors.initials: VA
authors.lastname: Lapin
authors.affiliation: Regional Oncology Dispensary, Volgograd, Russia.
authors.forename: K D
authors.initials: KD
authors.lastname: Kaplanov
authors.affiliation: Research Institute of Fundamental and Clinical Immunology, Novosibirsk, Russia.
authors.forename: I V
authors.initials: IV
authors.lastname: Kryuchkova
authors.affiliation: City Clinical Hospital Seventeen, Saint Petersburg, Russia.
authors.forename: A S
authors.initials: AS
authors.lastname: Nizamutdinova
authors.affiliation: City Clinical Hospital Thirty-One, Saint Petersburg, Russia.
authors.forename: A V
authors.initials: AV
authors.lastname: Klimovich
authors.affiliation: Regional Clinical Hospital, Kaluga, Russia.
authors.forename: E A
authors.initials: EA
authors.lastname: Borisenkova
authors.affiliation: Krasnoyarsk Clinical Hospital, Krasnoyarsk, Russia.
authors.forename: V I
authors.initials: VI
authors.lastname: Moskov
authors.affiliation: Hematology Research Center, Ministry of Health of Russia, Moscow, Russia.
authors.forename: T V
authors.initials: TV
authors.lastname: Gaponova
authors.affiliation: Hematology Research Center, Ministry of Health of Russia, Moscow, Russia.
authors.forename: T V
authors.initials: TV
authors.lastname: Obukhova
authors.affiliation: Hematology Research Center, Ministry of Health of Russia, Moscow, Russia.
authors.forename: I V
authors.initials: IV
authors.lastname: Galtseva
authors.affiliation: Hematology Research Center, Ministry of Health of Russia, Moscow, Russia.
authors.forename: M A
authors.initials: MA
authors.lastname: Rusinov
authors.affiliation: Hematology Research Center, Ministry of Health of Russia, Moscow, Russia.
authors.forename: S M
authors.initials: SM
authors.lastname: Kulikov
authors.affiliation: Hematology Research Center, Ministry of Health of Russia, Moscow, Russia.
authors.forename: V G
authors.initials: VG
authors.lastname: Savchenko
mesh_terms: D000328:Adult; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D054218:Precursor T-Cell Lymphoblastic Leukemia-Lymphoma / Q000401:mortality / Q000601:surgery*; D012074:Remission Induction; D012189:Retrospective Studies; D012426:Russia / Q000453:epidemiology; D015996:Survival Rate / Q000639:trends; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult