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Autologous and allogeneic stem cell transplantation in adult ALL: the Swedish Adult ALL Group experience

Hallbook, H; Hagglund, H; Stockelberg, D; Nilsson, Per-Gunnar LU ; Karlsson, Karin LU ; Bjorkholm, M; Linderholm, M; Wahlin, A; Linder, O and Smedmyr, B (2005) In Bone Marrow Transplantation 35(12). p.1141-1148
Abstract
Adult patients with acute lymphoblastic leukaemia ( ALL) have been treated according to national protocols in Sweden since 1986. Stem cell transplantation (SCT) has been recommended in first remission for patients with risk factors for relapse, and for standard risk patients only after relapse. In this retrospective study, the results of autologous and allogeneic SCT in these populations were evaluated. In total, 187 patients with a median age of 34 years ( 17 - 66 years) underwent SCT. The 5-year disease-free survival (DFS), for all patients, was 26% (Confidence intervals (CI) 20 - 32%). The 5-year DFS was higher for patients transplanted in first remission 32% ( CI 24 - 40%) compared to 14% ( CI 5 - 23%; P<0.0001) in patients... (More)
Adult patients with acute lymphoblastic leukaemia ( ALL) have been treated according to national protocols in Sweden since 1986. Stem cell transplantation (SCT) has been recommended in first remission for patients with risk factors for relapse, and for standard risk patients only after relapse. In this retrospective study, the results of autologous and allogeneic SCT in these populations were evaluated. In total, 187 patients with a median age of 34 years ( 17 - 66 years) underwent SCT. The 5-year disease-free survival (DFS), for all patients, was 26% (Confidence intervals (CI) 20 - 32%). The 5-year DFS was higher for patients transplanted in first remission 32% ( CI 24 - 40%) compared to 14% ( CI 5 - 23%; P<0.0001) in patients transplanted beyond first remission. No significant differences in DFS ( P = 0.06) were determined between autologous, related donor and unrelated donor SCT in the whole cohort. A lower relapse rate was counterbalanced by higher treatment-related mortality in patients undergoing allogeneic SCT. In Philadelphia-positive ALL, allogeneic SCT was superior to autologous SCT, with a 5-year DFS of 30% ( CI 12 - 47%) vs 0% ( P = 0.04). Limited chronic graft-versus-host-disease (GVHD) was associated with an improved DFS of 53% ( CI 38 - 69%) compared to no chronic GVHD of 22% ( CI 10 - 36%; P = 0.0008), indicating a clinically important graft-versus-leukaemia effect. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
stem cell transplantation, acute lymphoblastic leukaemia, adults, versus host disease, graft
in
Bone Marrow Transplantation
volume
35
issue
12
pages
1141 - 1148
publisher
Nature Publishing Group
external identifiers
  • pmid:15834433
  • wos:000229578400003
  • scopus:21244500535
ISSN
1476-5365
DOI
10.1038/sj.bmt.1704974
language
English
LU publication?
yes
id
18509801-b8b6-4553-8718-3780b52d367d (old id 238793)
date added to LUP
2007-08-03 09:14:14
date last changed
2017-01-01 04:44:01
@article{18509801-b8b6-4553-8718-3780b52d367d,
  abstract     = {Adult patients with acute lymphoblastic leukaemia ( ALL) have been treated according to national protocols in Sweden since 1986. Stem cell transplantation (SCT) has been recommended in first remission for patients with risk factors for relapse, and for standard risk patients only after relapse. In this retrospective study, the results of autologous and allogeneic SCT in these populations were evaluated. In total, 187 patients with a median age of 34 years ( 17 - 66 years) underwent SCT. The 5-year disease-free survival (DFS), for all patients, was 26% (Confidence intervals (CI) 20 - 32%). The 5-year DFS was higher for patients transplanted in first remission 32% ( CI 24 - 40%) compared to 14% ( CI 5 - 23%; P&lt;0.0001) in patients transplanted beyond first remission. No significant differences in DFS ( P = 0.06) were determined between autologous, related donor and unrelated donor SCT in the whole cohort. A lower relapse rate was counterbalanced by higher treatment-related mortality in patients undergoing allogeneic SCT. In Philadelphia-positive ALL, allogeneic SCT was superior to autologous SCT, with a 5-year DFS of 30% ( CI 12 - 47%) vs 0% ( P = 0.04). Limited chronic graft-versus-host-disease (GVHD) was associated with an improved DFS of 53% ( CI 38 - 69%) compared to no chronic GVHD of 22% ( CI 10 - 36%; P = 0.0008), indicating a clinically important graft-versus-leukaemia effect.},
  author       = {Hallbook, H and Hagglund, H and Stockelberg, D and Nilsson, Per-Gunnar and Karlsson, Karin and Bjorkholm, M and Linderholm, M and Wahlin, A and Linder, O and Smedmyr, B},
  issn         = {1476-5365},
  keyword      = {stem cell transplantation,acute lymphoblastic leukaemia,adults,versus host disease,graft},
  language     = {eng},
  number       = {12},
  pages        = {1141--1148},
  publisher    = {Nature Publishing Group},
  series       = {Bone Marrow Transplantation},
  title        = {Autologous and allogeneic stem cell transplantation in adult ALL: the Swedish Adult ALL Group experience},
  url          = {http://dx.doi.org/10.1038/sj.bmt.1704974},
  volume       = {35},
  year         = {2005},
}