Favorable Outcome of Unrelated Cord Blood Transplantation for Philadelphia Chromosome–Positive Acute Lymphoblastic Leukemia

Autor: Osamu Sasaki, Kenichi Ishizawa, Noriko Fukuhara, Joji Yamamoto, Minami Fujiwara Yamada, Rie Ohba, Kyoko Inokura, Yuna Katsuoka, Yasushi Onishi, Hisayuki Yokoyama, Satoshi Ichikawa, Junichi Kameoka, Hiroto Ohguchi, Katsura Kohata, Yoko Okitsu, Hideo Harigae
Rok vydání: 2011
Předmět:
Male
Neoplasm
Residual
Transplantation Conditioning
medicine.medical_treatment
Fusion Proteins
bcr-abl
Graft vs Host Disease
Hematopoietic stem cell transplantation
Kaplan-Meier Estimate
Gastroenterology
Tyrosine-kinase inhibitor
Leukocyte Count
tyrosine kinase inhibitor
hemic and lymphatic diseases
Antineoplastic Combined Chemotherapy Protocols
Cord blood transplantation
Philadelphia Chromosome Positive
Remission Induction
Hematology
Middle Aged
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Combined Modality Therapy
Tissue Donors
Treatment Outcome
surgical procedures
operative
Female
Cord Blood Stem Cell Transplantation
Whole-Body Irradiation
medicine.drug
Adult
medicine.medical_specialty
Adolescent
medicine.drug_class
CBT
Young Adult
Internal medicine
medicine
Biomarkers
Tumor
Humans
Transplantation
Homologous
Sibling
Retrospective Studies
Transplantation
business.industry
Imatinib
Myeloablative Agonists
Surgery
Regimen
Unrelated bone marrow transplantation
business
Ph+ALL
Zdroj: Biology of Blood and Marrow Transplantation. 17(7):1093-1097
ISSN: 1083-8791
DOI: 10.1016/j.bbmt.2011.01.010
Popis: Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph(+)ALL) is one of the highest-risk ALL groups. Whenever possible, patients with Ph(+)ALL should undergo allogeneic hematopoietic stem cell transplantation (HSCT) after induction of remission. Although unrelated cord blood transplantation (CBT) has become a common treatment in adult patients who lack a sibling donor, data on the efficacy of CBT for Ph(+)ALL are limited. We analyzed the clinical outcomes of 20 Ph(+)ALL patients who underwent CBT (n = 8) or unrelated bone marrow transplantation (BMT) (n = 12). The median age was 41 years (range, 17-55 years). All but one of the patients were treated with an imatinib-based regimen before HSCT, and 19 patients were in first complete remission (CR) and 1 patient was in second CR at the time of HSCT. Seventeen patients received a myeloablative conditioning regimen containing 12 Gy of total-body irradiation, and 3 received a reduced-intensity conditioning regimen. After a median of 26 months of follow-up, estimated 3-year overall and leukemia-free survival rates were 100% and 85%, respectively, after CBT, and 49% and 38%, respectively, after unrelated BMT. The CBT group had significantly better overall survival than the BMT group (P = .02). Although BCR-ABL transcript was detected in 4 of 8 CBT patients at transplantation, 7 patients remained in molecular CR. Our findings suggest that CBT may be a viable option as postinduction therapy for Ph(+)ALL in patients lacking a sibling donor.
Databáze: OpenAIRE
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