Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

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

Research output: Contribution to journalJournal articleResearchpeer-review

  • Sebastian Giebel
  • Myriam Labopin
  • Michael Potter
  • Xavier Poiré
  • Henrik Sengeloev
  • Gerard Socié
  • Anne Huynh
  • Boris V Afanasyev
  • Urs Schanz
  • Olle Ringden
  • Peter Kalhs
  • Dietrich W Beelen
  • Antonio M Campos
  • Tamás Masszi
  • Jonathan Canaani
  • Mohamad Mohty
  • Arnon Nagler
View graph of relations

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.

Original languageEnglish
JournalEuropean journal of cancer (Oxford, England : 1990)
Volume96
Pages (from-to)73-81
Number of pages9
ISSN0959-8049
DOIs
Publication statusPublished - Jun 2018

    Research areas

  • 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

ID: 56566622