AUTOLOGOUS HEMATOPOIETIC STEM CELL TRANSPLANTATION FOR HIGH-RISK ACUTE LYMPHOBLASTIC LEUKEMIA: NON-RANDOMIZED STUDY WITH A MAXIMUM FOLLOW-UP OF MORE THAN 22 YEARS

Grzegorz Helbig, Malgorzata Krawczyk-Kulis, Malgorzata Kopera, Krystyna Jagoda, Patrycja Rzepka, Aleksandra Majewska-Tessar, Marta Hejla, Slawomira Kyrcz-Krzemien
  • Malgorzata Krawczyk-Kulis
    Affiliation not present
  • Malgorzata Kopera
    Affiliation not present
  • Krystyna Jagoda
    Affiliation not present
  • Patrycja Rzepka
    Affiliation not present
  • Aleksandra Majewska-Tessar
    Affiliation not present
  • Marta Hejla
    Affiliation not present
  • Slawomira Kyrcz-Krzemien
    Affiliation not present

Abstract

Objective. To evaluate the efficacy and toxicity of autologous hematopoietic stem cell transplantation (AHSCT) for high-risk acute lymphoblastic leukemia (ALL).

Material and methods. Overall, 128 high-risk ALL patients at a median age of 26 years (range 18-56 years) at diagnosis received AHSCT between 1991-2008. Induction treatment was anthracycline-based in all patients. Conditioning regimen consisted of CAV (cyclophosphamide, cytarabine, etoposide) in 125 patients whereas 3 subjects received cyclophosphamide and TBI (total body irridation). Bone marrow was stored for 72 hours in 4oC and re-infused 24 hours after conditioning completion. Bone marrow was a source of stem cells in 119 patients, peripheral blood in 2 and 7 subjects received both bone marrow and peripheral blood.

Results. With a median follow-up after AHSCT of 1.6 years (range 0.1-22.3 years), the probability of leukemia-free survival (LFS) for the whole group at 10 years was 27% and 23% at 20 years. Transplant-related mortality at 100 days after AHSCT was 3.2%.. There was a strong tendency for better LFS for MRD-negative patients if compared with patients who had positive or unknown MRD status at AHSCT (32% vs 23% and 25%, respectively; p=0.06). There was no difference in LFS between B- and T-lineage ALL as well as between patients transplanted in first complete remission (CR1) and CR2. LFS at 10 years for patients with detectable BCR-ABL at transplant was 20% and this was comparable with subjects with negative and missing BCR-ABL status (26% and 28%; p=0.97).

Conclusions. The results of AHSCT for high-risk ALL remains unsatisfactory with low probability of long-term LFS.

Keywords

acute lymphoblastic leukemia, autologous hematopoietic stem cell transplantation, minimal residual disease, outcome

Full Text:

PDF
HTML
Submitted: 2014-07-21 14:09:32
Published: 2014-06-29 00:00:00
Search for citations in Google Scholar
Related articles: Google Scholar
Abstract views:
230

Views:
PDF
219
HTML
834

Article Metrics

Metrics Loading ...

Metrics powered by PLOS ALM


Copyright (c) 2016 Mediterranean Journal of Hematology and Infectious Diseases

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Ā 

The Mediterranean Journal of Hematology and Infectious Diseases [eISSN 2035-3006] is owned by the U.C.S.C. and it is published by PAGEPressĀ®, Pavia, Italy. All credits and honors to PKP for their OJS.
 
 
© PAGEPress 2008-2017     -     PAGEPress is a registered trademark property of PAGEPress srl, Italy.     -     VAT: IT02125780185