title: Evaluation of allogeneic transplantation in first or later minimal residual disease - negative remission following adult-inspired therapy for acute lymphoblastic leukemia.
abstract: Comparisons without hematopoietic cell transplantation (HCT) to myeloablative (MAC) or reduced-intensity HCT (RIC) for adults with acute lymphoblastic leukemia (ALL) in first minimal-residual-disease negative remission (MRD(Neg) CR1) are limited. Further, the importance of MRD(Neg) following salvage therapy (MRD(Neg) CR2+) is unknown. We evaluated 89 patients in MRD(Neg) CR1 after adult-inspired treatment: 33 received MAC (12 Philadelphia chromosome [Ph]+), 17 received RIC (13 Ph+), and 39 Deferred HCT (3 Ph+). Three-year overall survival (OS) estimates for MAC, RIC, and Deferred HCT were 71%, 69%, and 68%, while 3-year event-free survival (EFS) estimates were 65%, 54%, and 28%, respectively. Further, HCT in MRD(Neg) CR1 performed similarly to MRD(Neg) CR2+: 3-year OS estimates were 70% and 69%, and 3-year EFS estimates were 62% and 62%, respectively. In conclusion, adults with ALL in MRD(Neg) CR1 following adult-inspired therapy had similar OS with or without HCT, and HCT in MRD(Neg) CR2 + can yield long-term survival.
authors.affiliation: a Department of Medicine , University of Washington School of Medicine , Seattle , WA , USA ;|b Clinical Research Division , Fred Hutchinson Cancer Research Center , Seattle , WA , USA ;
authors.forename: Ryan D
authors.initials: RD
authors.lastname: Cassaday
authors.affiliation: a Department of Medicine , University of Washington School of Medicine , Seattle , WA , USA ;
authors.forename: D
authors.initials: D
authors.lastname: Alan Potts
authors.affiliation: b Clinical Research Division , Fred Hutchinson Cancer Research Center , Seattle , WA , USA ;
authors.forename: Philip A
authors.initials: PA
authors.lastname: Stevenson
authors.affiliation: a Department of Medicine , University of Washington School of Medicine , Seattle , WA , USA ;|b Clinical Research Division , Fred Hutchinson Cancer Research Center , Seattle , WA , USA ;
authors.forename: Merav
authors.initials: M
authors.lastname: Bar
authors.affiliation: a Department of Medicine , University of Washington School of Medicine , Seattle , WA , USA ;|b Clinical Research Division , Fred Hutchinson Cancer Research Center , Seattle , WA , USA ;
authors.forename: George E
authors.initials: GE
authors.lastname: Georges
authors.affiliation: a Department of Medicine , University of Washington School of Medicine , Seattle , WA , USA ;|b Clinical Research Division , Fred Hutchinson Cancer Research Center , Seattle , WA , USA ;
authors.forename: Andrei R
authors.initials: AR
authors.lastname: Shustov
authors.affiliation: a Department of Medicine , University of Washington School of Medicine , Seattle , WA , USA ;|b Clinical Research Division , Fred Hutchinson Cancer Research Center , Seattle , WA , USA ;
authors.forename: Mohamed L
authors.initials: ML
authors.lastname: Sorror
authors.affiliation: c Department of Laboratory Medicine & Pathology , University of Washington School of Medicine , Seattle , WA , USA ;
authors.forename: Brent L
authors.initials: BL
authors.lastname: Wood
authors.affiliation: b Clinical Research Division , Fred Hutchinson Cancer Research Center , Seattle , WA , USA ;|d Department of Pediatrics , University of Washington School of Medicine , Seattle , WA , USA.
authors.forename: Colleen
authors.initials: C
authors.lastname: Delaney
authors.affiliation: a Department of Medicine , University of Washington School of Medicine , Seattle , WA , USA ;|b Clinical Research Division , Fred Hutchinson Cancer Research Center , Seattle , WA , USA ;
authors.forename: Kristine C
authors.initials: KC
authors.lastname: Doney
authors.affiliation: a Department of Medicine , University of Washington School of Medicine , Seattle , WA , USA ;|b Clinical Research Division , Fred Hutchinson Cancer Research Center , Seattle , WA , USA ;
authors.forename: Rainer F
authors.initials: RF
authors.lastname: Storb
authors.affiliation: a Department of Medicine , University of Washington School of Medicine , Seattle , WA , USA ;|b Clinical Research Division , Fred Hutchinson Cancer Research Center , Seattle , WA , USA ;
authors.forename: Brenda M
authors.initials: BM
authors.lastname: Sandmaier
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual / Q000473:pathology*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D016016:Proportional Hazards Models; D012074:Remission Induction; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult
keywords: Chemotherapeutic approaches; clinical results; lymphoid leukemia; marrow and stem cell transplantation; neoplasia; prognostication