Thiotepa-based conditioning for allogeneic stem cell transplantation in acute lymphoblastic leukemia-A survey from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation.
In this study, we analyzed a thiotepa-based conditioning regimen for allogeneic stem cell transplantation in adults with acute lymphoblastic leukemia, using the EBMT database. A total of 323 patients were identified. The median age was 43 years. Disease status at transplant was first complete remission (CR1) in 48.9%, CR2 in 21.7%, CR3 in 6.2%, while 23.2% of the patients had an active disease at the time of transplant. This was performed from a HLA-matched sibling (49.8%) or a matched-unrelated donor (51.2%). The incidence of acute graft-vs.-host disease (GvHD) (grade > II) was 26.6%, while chronic GvHD occurred in 35.9% of the patients at 1 year (24.6% with extensive disease). With a median follow-up of 16.8 months, the nonrelapse mortality was 12.4 and 25.3% at 100 days and 1 year, respectively. The relapse incidence at 1 year was 33.3% with no difference for patients in CR1 (27%). The one-year leukemia-free survival (LFS) and overall survival (OS) were 57 and 66%, respectively for the entire cohort and 50 and 66%, respectively in patients in CR1. Thiotepa/busulfan ± melphalan (n = 213) in comparison to thiotepa/other (n = 110) conditioning regimen resulted in higher relapse incidence at 1 year (34.9 vs. 30.3%, P = 0.016) and lower LFS (38.8 vs. 45.9%, P = 0.0203), while nonrelapse mortality (23.8 vs. 26.3%, n.s.) and OS (59.6 vs. 51.1%, P = 0.109) did not differ. This large study suggests that a thiotepa-based conditioning for allogeneic transplantation in acute lymphoblastic leukemia is feasible and effective, with the main outcomes being comparable to those achieved with other regimens. Am. J. Hematol. 92:18-22, 2017. © 2016 Wiley Periodicals, Inc.
EBMT Office Paris, Hôpital Saint-Antoine, Paris, France.|Service d'Hématologie Clinique et de Thérapie Cellulaire, Hôpital Saint-Antoine, Paris, France.
Sandra
S
Eder
EBMT Office Paris, Hôpital Saint-Antoine, Paris, France.
Eric
E
Beohou
EBMT Office Paris, Hôpital Saint-Antoine, Paris, France.
Myriam
M
Labopin
Servicio de Hematología, Hospital Universitari i politècnic La Fe, Valencia, Spain.
Jaime
J
Sanz
Hematology/Oncology, University Medical Center Freiburg, Freiburg, Germany.
Jürgen
J
Finke
Department of Hematology and Transplant, University of Rome 'Tor Vergata', Rome, Italy.
William
W
Arcese
Bone Marrow Transplantation, Hadassah University Hospital, Jerusalem, Israel.
Reuven
R
Or
S.Orsola-Malpighi Hospital Institute of Hematology and Medical, Oncology L and A Seràgnoli, Bologna University, Bologna, Italy.
Francesca
F
Bonifazi
Oncology (Section of Adult Haematolgy/BMT), King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
Mahmoud
M
Aljurf
Department of Hematology, BMT, Hospital St. Louis, Paris, France.
Gerard
G
Socié
Hematology, University Hospital, Basel, Switzerland.
Jakob
J
Passweg
EBMT Office Paris, Hôpital Saint-Antoine, Paris, France.|Gliwice Branch, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice, Poland.
Sebastian
S
Giebel
EBMT Office Paris, Hôpital Saint-Antoine, Paris, France.|Service d'Hématologie Clinique et de Thérapie Cellulaire, Hôpital Saint-Antoine, Paris, France.
Mohamad
M
Mohty
EBMT Office Paris, Hôpital Saint-Antoine, Paris, France.|Hematology Division, Chaim Sheba Medical Center and Tel Aviv University, Tel-Hashomer, Ramat-Gan, Israel.
Arnon
A
Nagler
D000293:Adolescent; D000328:Adult; D000368:Aged; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage / Q000627:therapeutic use*; D018572:Disease-Free Survival; D005260:Female; D006086:Graft vs Host Disease / Q000453:epidemiology / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006648:Histocompatibility / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000276:immunology / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies; D013852:Thiotepa / Q000008:administration & dosage / Q000627:therapeutic use*; D019172:Transplantation Conditioning / Q000379:methods*; D014184:Transplantation, Homologous; D055815:Young Adult
D018906:Antineoplastic Agents, Alkylating; D013852:Thiotepa