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Comparison of haplo-SCT and chemotherapy for young adults with standard-risk Ph-negative acute lymphoblastic leukemia in CR1.
J Hematol Oncol. 2020 05 15; 13(1):52.JH

Abstract

Human leukocyte antigen (HLA) haploidentical stem cell transplantation (haplo-SCT) as a postremission treatment for standard risk Philadelphia chromosome-negative acute lymphoblastic leukemia (SR Ph-ALL) in the first complete remission (CR1) has not been defined. In this multicenter, phase 3 study (NCT02042690), of the 131 consecutive Ph-ALL young adult patients (YA, aged 18-39 years) without high-risk features who achieved CR1, 114 patients without HLA-matched donors received consolidation with an adult chemotherapy regimen (n = 55) or haplo-SCT (n = 59). In the landmark analysis, haplo-SCT resulted in a lower 2-year cumulative incidence of relapse (CIR, 12.8% vs 46.7%, P = 0.0017) and superior 2-year leukemia-free survival (LFS, 80.9% vs 51.1%, P = 0.0116) and 2-year overall survival (OS, 91.2% vs 75.7 [64.8-93.2] %, P = 0.0408) than chemotherapy. In the time-dependent multivariate analysis with propensity score adjustment, postremission treatment (haplo-SCT vs chemotherapy) was an independent risk factor for the CIR (HR 0.195, 95% CI 0.076-0.499, P = 0.001), LFS (HR 0.297, 95% CI 0.131-0.675, P = 0.003), and OS (HR 0.346, 95% CI 0.140-0.853, P = 0.011). In all subgroups, CIR was lower in haplo-SCT. Myeloablative haplo-SCT with ATG+G-CSF might be one of the preferred therapies for YA patients with standard-risk Ph-ALL.

TRIAL REGISTRATION:

ClinicalTrials.gov. Registered on 23 January 2014, https://clinicaltrials.gov/ct2/show/NCT02042690.

Authors+Show Affiliations

Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, National Clinical Research Center for Hematologic Disease, Beijing, China.Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, National Clinical Research Center for Hematologic Disease, Beijing, China.Peking Union Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.General Hospital of PLA (People's Liberation Army of China), Beijing, China.The First Affiliated Hospital of Soochow University, National Clinical Research Center for Hematologic Disease, Suzhou, China.Peking University Aerospace Center Hospital, Beijing, China.Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, National Clinical Research Center for Hematologic Disease, Beijing, China.Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, National Clinical Research Center for Hematologic Disease, Beijing, China.Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, National Clinical Research Center for Hematologic Disease, Beijing, China.Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, National Clinical Research Center for Hematologic Disease, Beijing, China.Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, National Clinical Research Center for Hematologic Disease, Beijing, China.Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, National Clinical Research Center for Hematologic Disease, Beijing, China.Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, National Clinical Research Center for Hematologic Disease, Beijing, China.Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, National Clinical Research Center for Hematologic Disease, Beijing, China. xjhrm@medmail.com.cn. Peking-Tsinghua Center for Life Sciences, Beijing, China. xjhrm@medmail.com.cn. Research Unit of Key Technique for Diagnosis and Treatments of Hematologic Malignancies (2019RU029), Chinese Academy of Medical Sciences, Beijing, China. xjhrm@medmail.com.cn.

Pub Type(s)

Letter
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32414392

Citation

Lv, Meng, et al. "Comparison of haplo-SCT and Chemotherapy for Young Adults With Standard-risk Ph-negative Acute Lymphoblastic Leukemia in CR1." Journal of Hematology & Oncology, vol. 13, no. 1, 2020, p. 52.
Lv M, Jiang Q, Zhou DB, et al. Comparison of haplo-SCT and chemotherapy for young adults with standard-risk Ph-negative acute lymphoblastic leukemia in CR1. J Hematol Oncol. 2020;13(1):52.
Lv, M., Jiang, Q., Zhou, D. B., Hu, Y., Liu, D. H., Wu, D. P., Wang, J. B., Jiang, H., Wang, J., Chang, Y. J., Wang, Y., Zhang, X. H., Xu, L. P., Liu, K. Y., & Huang, X. J. (2020). Comparison of haplo-SCT and chemotherapy for young adults with standard-risk Ph-negative acute lymphoblastic leukemia in CR1. Journal of Hematology & Oncology, 13(1), 52. https://doi.org/10.1186/s13045-020-00879-1
Lv M, et al. Comparison of haplo-SCT and Chemotherapy for Young Adults With Standard-risk Ph-negative Acute Lymphoblastic Leukemia in CR1. J Hematol Oncol. 2020 05 15;13(1):52. PubMed PMID: 32414392.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of haplo-SCT and chemotherapy for young adults with standard-risk Ph-negative acute lymphoblastic leukemia in CR1. AU - Lv,Meng, AU - Jiang,Qian, AU - Zhou,Dao-Bin, AU - Hu,Yu, AU - Liu,Dai-Hong, AU - Wu,De-Pei, AU - Wang,Jing-Bo, AU - Jiang,Hao, AU - Wang,Jing, AU - Chang,Ying-Jun, AU - Wang,Yu, AU - Zhang,Xiao-Hui, AU - Xu,Lan-Ping, AU - Liu,Kai-Yan, AU - Huang,Xiao-Jun, Y1 - 2020/05/15/ PY - 2020/03/11/received PY - 2020/04/23/accepted PY - 2020/5/17/entrez PY - 2020/5/18/pubmed PY - 2020/5/18/medline KW - Adult chemotherapy KW - Haplo-SCT KW - Ph-negative acute lymphoblastic leukemia SP - 52 EP - 52 JF - Journal of hematology & oncology JO - J Hematol Oncol VL - 13 IS - 1 N2 - Human leukocyte antigen (HLA) haploidentical stem cell transplantation (haplo-SCT) as a postremission treatment for standard risk Philadelphia chromosome-negative acute lymphoblastic leukemia (SR Ph-ALL) in the first complete remission (CR1) has not been defined. In this multicenter, phase 3 study (NCT02042690), of the 131 consecutive Ph-ALL young adult patients (YA, aged 18-39 years) without high-risk features who achieved CR1, 114 patients without HLA-matched donors received consolidation with an adult chemotherapy regimen (n = 55) or haplo-SCT (n = 59). In the landmark analysis, haplo-SCT resulted in a lower 2-year cumulative incidence of relapse (CIR, 12.8% vs 46.7%, P = 0.0017) and superior 2-year leukemia-free survival (LFS, 80.9% vs 51.1%, P = 0.0116) and 2-year overall survival (OS, 91.2% vs 75.7 [64.8-93.2] %, P = 0.0408) than chemotherapy. In the time-dependent multivariate analysis with propensity score adjustment, postremission treatment (haplo-SCT vs chemotherapy) was an independent risk factor for the CIR (HR 0.195, 95% CI 0.076-0.499, P = 0.001), LFS (HR 0.297, 95% CI 0.131-0.675, P = 0.003), and OS (HR 0.346, 95% CI 0.140-0.853, P = 0.011). In all subgroups, CIR was lower in haplo-SCT. Myeloablative haplo-SCT with ATG+G-CSF might be one of the preferred therapies for YA patients with standard-risk Ph-ALL. TRIAL REGISTRATION: ClinicalTrials.gov. Registered on 23 January 2014, https://clinicaltrials.gov/ct2/show/NCT02042690. SN - 1756-8722 UR - https://www.unboundmedicine.com/medline/citation/32414392/Comparison_of_haplo-SCT_and_chemotherapy_for_young_adults_with_standard-risk_Ph-negative_acute_lymphoblastic_leukemia_in_CR1 L2 - https://jhoonline.biomedcentral.com/articles/10.1186/s13045-020-00879-1 DB - PRIME DP - Unbound Medicine ER -
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