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Comparable results of autologous and allogeneic haematopoietic stem cell transplantation for adults with Philadelphia-positive acute lymphoblastic leukaemia in first complete molecular remission: An analysis by the Acute Leukemia Working Party of the EBMT

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Giebel, Sebastian ; Labopin, Myriam ; Potter, Michael ; Poiré, Xavier ; Sengeloev, Henrik ; Socié, Gerard ; Huynh, Anne ; Afanasyev, Boris V ; Schanz, Urs ; Ringden, Olle ; Kalhs, Peter ; Beelen, Dietrich W ; Campos, Antonio M ; Masszi, Tamás ; Canaani, Jonathan ; Mohty, Mohamad ; Nagler, Arnon. / Comparable results of autologous and allogeneic haematopoietic stem cell transplantation for adults with Philadelphia-positive acute lymphoblastic leukaemia in first complete molecular remission : An analysis by the Acute Leukemia Working Party of the EBMT. I: European journal of cancer (Oxford, England : 1990). 2018 ; Bind 96. s. 73-81.

Bibtex

@article{af2af6e0bb534edc9cbda1847fae8c85,
title = "Comparable results of autologous and allogeneic haematopoietic stem cell transplantation for adults with Philadelphia-positive acute lymphoblastic leukaemia in first complete molecular remission: An analysis by the Acute Leukemia Working Party of the EBMT",
abstract = "BACKGROUND: Allogeneic haematopoietic stem cell transplantation (alloHSCT) is considered a standard treatment for patients with Philadelphia chromosome-positive acute lymphoblastic leukaemia (Ph+ ALL) achieving complete remission after induction containing tyrosine kinase inhibitors (TKIs).METHODS: We retrospectively compared results of myeloablative alloHSCT from either matched sibling donor (MSD) or unrelated donor (URD) with autologous (auto) HSCT for adults with Ph+ ALL in molecular remission, treated between 2007 and 2014.RESULTS: In univariate analysis, the incidence of relapse at 2 years was 47% after autoHSCT, 28% after MSD-HSCT and 19% after URD-HSCT (P = 0.0002). Respective rates of non-relapse mortality were 2%, 18%, and 22% (P = 0.001). The probabilities of leukaemia-free survival were 52%, 55% and 60% (P = 0.69), while overall survival rates were 70%, 70% and 69% (P = 0.58), respectively. In multivariate analysis, there was a trend towards increased risk of overall mortality after MSD-HSCT (hazard ratio [HR], 1.5, P = 0.12) and URD-HSCT (HR, 1.6, P = 0.08) when referred to autoHSCT. The use of total body irradiation (TBI)-based regimens was associated with reduced risk of relapse (HR, 0.65, P = 0.02) and overall mortality (HR, 0.67, P = 0.01).CONCLUSION: In the era of TKIs, outcomes of myeloablative autoHSCT and alloHSCT for patients with Ph+ ALL in first molecular remission are comparable. Therefore, autoHSCT appears to be an attractive treatment option potentially allowing for circumvention of alloHSCT sequelae. Irrespective of the type of donor, TBI-based regimens should be considered the preferable type of conditioning for Ph+ ALL.",
keywords = "Adolescent, Adult, Aged, Clinical Decision-Making, Europe, Female, Genetic Predisposition to Disease, Hematopoietic Stem Cell Transplantation/adverse effects, Humans, Israel, Male, Middle Aged, Phenotype, Philadelphia Chromosome, Precursor Cell Lymphoblastic Leukemia-Lymphoma/enzymology, Protein Kinase Inhibitors/therapeutic use, Registries, Remission Induction, Retrospective Studies, Risk Factors, Time Factors, Transplantation Conditioning/methods, Transplantation, Autologous, Transplantation, Homologous, Treatment Outcome, Young Adult",
author = "Sebastian Giebel and Myriam Labopin and Michael Potter and Xavier Poir{\'e} and Henrik Sengeloev and Gerard Soci{\'e} and Anne Huynh and Afanasyev, {Boris V} and Urs Schanz and Olle Ringden and Peter Kalhs and Beelen, {Dietrich W} and Campos, {Antonio M} and Tam{\'a}s Masszi and Jonathan Canaani and Mohamad Mohty and Arnon Nagler",
note = "Copyright {\textcopyright} 2018 Elsevier Ltd. All rights reserved.",
year = "2018",
month = jun,
doi = "10.1016/j.ejca.2018.03.018",
language = "English",
volume = "96",
pages = "73--81",
journal = "European Journal of Cancer, Supplement",
issn = "0959-8049",
publisher = "Pergamon",

}

RIS

TY - JOUR

T1 - Comparable results of autologous and allogeneic haematopoietic stem cell transplantation for adults with Philadelphia-positive acute lymphoblastic leukaemia in first complete molecular remission

T2 - An analysis by the Acute Leukemia Working Party of the EBMT

AU - Giebel, Sebastian

AU - Labopin, Myriam

AU - Potter, Michael

AU - Poiré, Xavier

AU - Sengeloev, Henrik

AU - Socié, Gerard

AU - Huynh, Anne

AU - Afanasyev, Boris V

AU - Schanz, Urs

AU - Ringden, Olle

AU - Kalhs, Peter

AU - Beelen, Dietrich W

AU - Campos, Antonio M

AU - Masszi, Tamás

AU - Canaani, Jonathan

AU - Mohty, Mohamad

AU - Nagler, Arnon

N1 - Copyright © 2018 Elsevier Ltd. All rights reserved.

PY - 2018/6

Y1 - 2018/6

N2 - BACKGROUND: Allogeneic haematopoietic stem cell transplantation (alloHSCT) is considered a standard treatment for patients with Philadelphia chromosome-positive acute lymphoblastic leukaemia (Ph+ ALL) achieving complete remission after induction containing tyrosine kinase inhibitors (TKIs).METHODS: We retrospectively compared results of myeloablative alloHSCT from either matched sibling donor (MSD) or unrelated donor (URD) with autologous (auto) HSCT for adults with Ph+ ALL in molecular remission, treated between 2007 and 2014.RESULTS: In univariate analysis, the incidence of relapse at 2 years was 47% after autoHSCT, 28% after MSD-HSCT and 19% after URD-HSCT (P = 0.0002). Respective rates of non-relapse mortality were 2%, 18%, and 22% (P = 0.001). The probabilities of leukaemia-free survival were 52%, 55% and 60% (P = 0.69), while overall survival rates were 70%, 70% and 69% (P = 0.58), respectively. In multivariate analysis, there was a trend towards increased risk of overall mortality after MSD-HSCT (hazard ratio [HR], 1.5, P = 0.12) and URD-HSCT (HR, 1.6, P = 0.08) when referred to autoHSCT. The use of total body irradiation (TBI)-based regimens was associated with reduced risk of relapse (HR, 0.65, P = 0.02) and overall mortality (HR, 0.67, P = 0.01).CONCLUSION: In the era of TKIs, outcomes of myeloablative autoHSCT and alloHSCT for patients with Ph+ ALL in first molecular remission are comparable. Therefore, autoHSCT appears to be an attractive treatment option potentially allowing for circumvention of alloHSCT sequelae. Irrespective of the type of donor, TBI-based regimens should be considered the preferable type of conditioning for Ph+ ALL.

AB - BACKGROUND: Allogeneic haematopoietic stem cell transplantation (alloHSCT) is considered a standard treatment for patients with Philadelphia chromosome-positive acute lymphoblastic leukaemia (Ph+ ALL) achieving complete remission after induction containing tyrosine kinase inhibitors (TKIs).METHODS: We retrospectively compared results of myeloablative alloHSCT from either matched sibling donor (MSD) or unrelated donor (URD) with autologous (auto) HSCT for adults with Ph+ ALL in molecular remission, treated between 2007 and 2014.RESULTS: In univariate analysis, the incidence of relapse at 2 years was 47% after autoHSCT, 28% after MSD-HSCT and 19% after URD-HSCT (P = 0.0002). Respective rates of non-relapse mortality were 2%, 18%, and 22% (P = 0.001). The probabilities of leukaemia-free survival were 52%, 55% and 60% (P = 0.69), while overall survival rates were 70%, 70% and 69% (P = 0.58), respectively. In multivariate analysis, there was a trend towards increased risk of overall mortality after MSD-HSCT (hazard ratio [HR], 1.5, P = 0.12) and URD-HSCT (HR, 1.6, P = 0.08) when referred to autoHSCT. The use of total body irradiation (TBI)-based regimens was associated with reduced risk of relapse (HR, 0.65, P = 0.02) and overall mortality (HR, 0.67, P = 0.01).CONCLUSION: In the era of TKIs, outcomes of myeloablative autoHSCT and alloHSCT for patients with Ph+ ALL in first molecular remission are comparable. Therefore, autoHSCT appears to be an attractive treatment option potentially allowing for circumvention of alloHSCT sequelae. Irrespective of the type of donor, TBI-based regimens should be considered the preferable type of conditioning for Ph+ ALL.

KW - Adolescent

KW - Adult

KW - Aged

KW - Clinical Decision-Making

KW - Europe

KW - Female

KW - Genetic Predisposition to Disease

KW - Hematopoietic Stem Cell Transplantation/adverse effects

KW - Humans

KW - Israel

KW - Male

KW - Middle Aged

KW - Phenotype

KW - Philadelphia Chromosome

KW - Precursor Cell Lymphoblastic Leukemia-Lymphoma/enzymology

KW - Protein Kinase Inhibitors/therapeutic use

KW - Registries

KW - Remission Induction

KW - Retrospective Studies

KW - Risk Factors

KW - Time Factors

KW - Transplantation Conditioning/methods

KW - Transplantation, Autologous

KW - Transplantation, Homologous

KW - Treatment Outcome

KW - Young Adult

U2 - 10.1016/j.ejca.2018.03.018

DO - 10.1016/j.ejca.2018.03.018

M3 - Journal article

C2 - 29679774

VL - 96

SP - 73

EP - 81

JO - European Journal of Cancer, Supplement

JF - European Journal of Cancer, Supplement

SN - 0959-8049

ER -

ID: 56566622