Optimal treatment for Philadelphia-negative acute lymphoblastic leukemia in first remission in the era of high-intensity chemotherapy
Autor: | Heiwa Kanamori, Tohru Murayama, Yasushi Miyazaki, Yukiyasu Ozawa, Yoshiko Atsuta, Tatsuo Ichinohe, Junichi Mukae, Tadakazu Kondo, Noriko Usui, Yoshinori Tanaka, Kiyotoshi Imai, Junji Tanaka, Shuichi Ota, Fumihiko Hayakawa, Satoshi Nishiwaki, Shigeki Ohtake, Takahiro Fukuda, Shuichi Mizuta, Itaru Matsumura, Shinichi Kako, Shingo Kurahashi, Hitoshi Kiyoi, Toru Sakura |
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Rok vydání: | 2021 |
Předmět: |
Adult
Male medicine.medical_specialty Transplantation Conditioning Lymphoblastic Leukemia medicine.medical_treatment Clinical Decision-Making Hematopoietic stem cell transplantation Philadelphia chromosome hemic and lymphatic diseases Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Transplantation Homologous Aged Philadelphia negative Aged 80 and over Chemotherapy Hematology business.industry Optimal treatment Histocompatibility Testing Remission Induction Hematopoietic Stem Cell Transplantation Disease Management Middle Aged Precursor Cell Lymphoblastic Leukemia-Lymphoma medicine.disease Prognosis Combined Modality Therapy Survival Analysis Leukemia surgical procedures operative Treatment Outcome Female business |
Zdroj: | International journal of hematology. 114(5) |
ISSN: | 1865-3774 |
Popis: | The optimal treatment for Philadelphia chromosome (Ph)-negative acute lymphoblastic leukemia (ALL) in first complete remission (CR1) has not been established in the high-intensity chemotherapy era. The outcomes of patients with Ph-negative ALL who underwent allogeneic hematopoietic stem cell transplantation (HSCT) from a human leukocyte antigen-matched related or unrelated donor in CR1 (HSCT-MRD group and HSCT-MUD group) were obtained from a Japanese registry database. Patients aged 16–24 years and 25–65 years were analyzed separately, and their outcomes were compared to those of patients who continued high-intensity chemotherapy in CR1 in studies (202U group and 202O group) by the Japan Adult Leukemia Study Group (JALSG). In the HSCT-MRD group, patients younger than 25 years had lower overall survival (OS) than the 202U group, presumably due to the higher non-relapse mortality (NRM) in the HSCT-MRD group. Patients 25 years and older had similar OS to the 202O group. The lower relapse rate was counterbalanced by higher NRM in the HSCT-MRD group. In the HSCT-MUD group, patients in both age groups had similar OS to their corresponding groups in the JALSG studies. In conclusion, high-intensity chemotherapy may change the role of HSCT for Ph-negative ALL. |
Databáze: | OpenAIRE |
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