Beelen, Dietrich W. and Arnold, Renate and Stelljes, Matthias and Alakel, Nael and Brecht, Arne and Bug, Gesine and Bunjes, Donald and Faul, Christoph and Finke, Juergen and Franke, Georg-Nikolaus and Holler, Ernst and Kobbe, Guido and Kroeger, Nicolaus and Roesler, Wolf and Scheid, Christof and Schoenland, Stefan and Stadler, Michael and Tischer, Johanna and Wagner-Drouet, Eva and Wendelin, Knut and Brueggemann, Monika and Reiser, Lena and Hoelzer, Dieter and Goekbuget, Nicola (2022) Long-Term Results of Allogeneic Stem Cell Transplantation in Adult Ph- Negative High-Risk Acute Lymphoblastic Leukemia. TRANSPLANTATION AND CELLULAR THERAPY, 28 (12). pp. 834-842. ISSN 2666-6375, 2666-6367
Full text not available from this repository. (Request a copy)Abstract
Allogeneic hematopoietic stem cell transplantation (HCT) is standard treatment for adult high-risk (HR) acute lymphoblastic leukemia (ALL) and contributed to the overall improved outcome. We report a consecutive cohort of prospectively defined HR patients treated on German Multicenter Acute Lymphoblastic Leukemia trials 06/99-07/03 with similar induction/consolidation therapy and HCT in first remission. A total of 542 patients (15-55 years) with BCR-ABL-negative ALL were analyzed. Sixty-seven percent received HCT from matched unrelated donors (MUD) and 32% from matched sibling donors (MSD). The incidence of non-relapse mortality (NRM) was 20% at 5 years. NRM occurred after median 6.6 months; the leading cause (46%) was infection. NRM after MUD decreased from 39% in trial 06/99 to 16% in trial 07/03 (P < .00001). Patient age was the strongest predictor of NRM. The 5-year relapse incidence was 23% using MSD and 25% using MUD. Minimal residual disease (MRD) was the strongest predictor of relapse (45% for molecular failure versus 6% for molecular CR; P < .0001). The median follow-up was 67 months, and the 5-year survival rate was 58%. Age, subtype/high risk feature, MRD status, trial and acute GvHD were significant prognostic factors. We provide a large reference analysis with long follow-up confirming a similar outcome of MSD and MUD HCT and improved NRM for MUD HCT over years. MRD has a strong impact on relapse risk, whereas age was the strongest predictor of NRM. New adapted conditioning strategies should be considered for older patients combined with the goal to reduce the MRD level before stem cell transplantation.(c) 2022 The American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc. All rights reserved.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | MINIMAL RESIDUAL DISEASE; MULTIPARAMETER FLOW-CYTOMETRY; STANDARD-RISK; MARROW-TRANSPLANTATION; IDENTICAL SIBLINGS; IMPROVES SURVIVAL; MRD; QUANTIFICATION; CHILDHOOD; CONSENSUS; Adult High-risk ALL; Allogeneic SCT; Prospective GMALL Trials |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin III (Hämatologie und Internistische Onkologie) |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 14 Dec 2023 07:25 |
| Last Modified: | 14 Dec 2023 07:25 |
| URI: | https://pred.uni-regensburg.de/id/eprint/58688 |
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