Reduced-intensity allogeneic stem cell transplantation for patients aged 50 years or older with B-cell ALL in remission: a retrospective study by the Adult ALL Working Group of the Japan Society for Hematopoietic Cell Transplantation.

Abstract:

:We retrospectively assessed the outcome and pretransplantation predictors of the outcome in 118 patients aged ≥ 50 years who received fludarabine-containing reduced-intensity allo-SCT (RIST) for B-cell ALL in the first or second CR. Eighty patients received transplants from unrelated donors. Seventy-eight patients were positive for the Ph chromosome. The median follow-up period was 18 months and the 2-year OS rate was 56%. The 2-year cumulative incidence of relapse and non-relapse mortality was 28% and 26%, respectively. The incidence of grades II-IV and III-IV acute GVHD was 46% and 24%, respectively. After 2 years, the incidence of chronic GVHD was 37%. Multivariate analysis of pretransplant factors showed that a higher white blood cell count (≥ 30 × 10(9)/L) at diagnosis (hazard ratio (HR)=2.19, P=0.007) and second CR (HR=2.02, P=0.036) were significantly associated with worse OS, whereas second CR (HR=3.83, P<0.001) and related donor (HR=2.34, P=0.039) were associated with a higher incidence of relapse. Fludarabine-containing RIST may be a promising strategy for older patients with B-cell ALL in their first remission.

journal_name

Bone Marrow Transplant

authors

Kanamori H,Mizuta S,Kako S,Kato H,Nishiwaki S,Imai K,Shigematsu A,Nakamae H,Tanaka M,Ikegame K,Yujiri T,Fukuda T,Minagawa K,Eto T,Nagamura-Inoue T,Morishima Y,Suzuki R,Sakamaki H,Tanaka J

doi

10.1038/bmt.2013.140

subject

Has Abstract

pub_date

2013-11-01 00:00:00

pages

1513-8

issue

12

eissn

0268-3369

issn

1476-5365

pii

bmt2013140

journal_volume

48

pub_type

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