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Myeloablative allogeneic hematopoietic stem cell transplantation for Philadelphia chromosome-positive acute lymphoblastic leukemia in adults: significant roles of total body irradiation and chronic graft-versus-host disease.
Bone Marrow Transplant. 2005 Nov; 36(10):867-72.BM

Abstract

Disease-free survival in Philadelphia chromosome-positive ALL (Ph + ALL) is very poor, and allogeneic hematopoietic stem cell transplantation (allo-HSCT) is currently considered the only procedure with curative potential. To identify factors affecting transplant outcome, we analyzed the data from 197 Ph + ALL patients aged 16 years or older who had undergone allo-HSCT. The 5-year survival rates were 34% for patients in first complete remission (CR), 21% for those in second or subsequent CR, and 9% for those with active disease (P < 0.0001). Multivariate analysis showed four pre-transplant factors as significantly associated with better survival: younger age, CR at the time of transplantation, conditioning with total body irradiation, and HLA-identical sibling donor (P < 0.0001, P < 0.0001, P = 0.0301, P = 0.0412, respectively). Severe acute GVHD increased the risk of treatment-related mortality (TRM) without diminishing the risk of relapse, whereas chronic GVHD reduced the risk of relapse without increasing the risk of TRM. Thus, patients who developed extensive chronic GVHD had better survivals (P = 0.0217), and those who developed grade III-IV acute GVHD had worse survivals (P = 0.0023) than did the others.

Authors+Show Affiliations

Department of Hematology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan. myanada@med.nagoya-u.ac.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16113659

Citation

Yanada, M, et al. "Myeloablative Allogeneic Hematopoietic Stem Cell Transplantation for Philadelphia Chromosome-positive Acute Lymphoblastic Leukemia in Adults: Significant Roles of Total Body Irradiation and Chronic Graft-versus-host Disease." Bone Marrow Transplantation, vol. 36, no. 10, 2005, pp. 867-72.
Yanada M, Naoe T, Iida H, et al. Myeloablative allogeneic hematopoietic stem cell transplantation for Philadelphia chromosome-positive acute lymphoblastic leukemia in adults: significant roles of total body irradiation and chronic graft-versus-host disease. Bone Marrow Transplant. 2005;36(10):867-72.
Yanada, M., Naoe, T., Iida, H., Sakamaki, H., Sakura, T., Kanamori, H., Kodera, Y., Okamoto, S., Kanda, Y., Sao, H., Asai, O., Nakai, K., Maruta, A., Kishi, K., Furukawa, T., Atsuta, Y., Yamamoto, K., Tanaka, J., & Takahashi, S. (2005). Myeloablative allogeneic hematopoietic stem cell transplantation for Philadelphia chromosome-positive acute lymphoblastic leukemia in adults: significant roles of total body irradiation and chronic graft-versus-host disease. Bone Marrow Transplantation, 36(10), 867-72.
Yanada M, et al. Myeloablative Allogeneic Hematopoietic Stem Cell Transplantation for Philadelphia Chromosome-positive Acute Lymphoblastic Leukemia in Adults: Significant Roles of Total Body Irradiation and Chronic Graft-versus-host Disease. Bone Marrow Transplant. 2005;36(10):867-72. PubMed PMID: 16113659.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Myeloablative allogeneic hematopoietic stem cell transplantation for Philadelphia chromosome-positive acute lymphoblastic leukemia in adults: significant roles of total body irradiation and chronic graft-versus-host disease. AU - Yanada,M, AU - Naoe,T, AU - Iida,H, AU - Sakamaki,H, AU - Sakura,T, AU - Kanamori,H, AU - Kodera,Y, AU - Okamoto,S, AU - Kanda,Y, AU - Sao,H, AU - Asai,O, AU - Nakai,K, AU - Maruta,A, AU - Kishi,K, AU - Furukawa,T, AU - Atsuta,Y, AU - Yamamoto,K, AU - Tanaka,J, AU - Takahashi,S, PY - 2005/8/23/pubmed PY - 2005/12/29/medline PY - 2005/8/23/entrez SP - 867 EP - 72 JF - Bone marrow transplantation JO - Bone Marrow Transplant VL - 36 IS - 10 N2 - Disease-free survival in Philadelphia chromosome-positive ALL (Ph + ALL) is very poor, and allogeneic hematopoietic stem cell transplantation (allo-HSCT) is currently considered the only procedure with curative potential. To identify factors affecting transplant outcome, we analyzed the data from 197 Ph + ALL patients aged 16 years or older who had undergone allo-HSCT. The 5-year survival rates were 34% for patients in first complete remission (CR), 21% for those in second or subsequent CR, and 9% for those with active disease (P < 0.0001). Multivariate analysis showed four pre-transplant factors as significantly associated with better survival: younger age, CR at the time of transplantation, conditioning with total body irradiation, and HLA-identical sibling donor (P < 0.0001, P < 0.0001, P = 0.0301, P = 0.0412, respectively). Severe acute GVHD increased the risk of treatment-related mortality (TRM) without diminishing the risk of relapse, whereas chronic GVHD reduced the risk of relapse without increasing the risk of TRM. Thus, patients who developed extensive chronic GVHD had better survivals (P = 0.0217), and those who developed grade III-IV acute GVHD had worse survivals (P = 0.0023) than did the others. SN - 0268-3369 UR - https://www.unboundmedicine.com/medline/citation/16113659/Myeloablative_allogeneic_hematopoietic_stem_cell_transplantation_for_Philadelphia_chromosome_positive_acute_lymphoblastic_leukemia_in_adults:_significant_roles_of_total_body_irradiation_and_chronic_graft_versus_host_disease_ L2 - https://doi.org/10.1038/sj.bmt.1705148 DB - PRIME DP - Unbound Medicine ER -