Outcome of allogeneic bone marrow transplantation from unrelated donors for adult Philadelphia chromosome-negative acute lymphocytic leukemia in first complete-remission |
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Authors: | Satoshi Nishiwaki Seitaro Terakura Takahiko Yasuda Nobuhiko Imahashi Hiroshi Sao Hiroatsu Iida Yoshikazu Kamiya Keiko Niimi Yoshihisa Morishita Akio Kohno Toshiya Yokozawa Haruhiko Ohashi Masashi Sawa Yoshihisa Kodera Koichi Miyamura |
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Affiliation: | 1. Department of Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan 2. Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan 3. Department of Hematology, Meitetsu Hospital, Nagoya, Japan 4. Department of Hematology and Oncology, JA Aichi Konan Kosei Hospital, Konan, Japan 5. Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan 6. Department of Hematology, Anjo Kosei Hospital, Anjo, Japan
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Abstract: | The indication of allogeneic stem cell transplantation (allo-SCT) for Philadelphia chromosome-negative acute lymphocytic leukemia [Ph(?) ALL] from unrelated donors is not established. To assess its potency of unrelated patients in first complete-remission (CR1) transplanted from unrelated donors and the potential prognostic factors affecting the probability of survival, we retrospectively analyzed a total of 41 adult Ph(?) ALL patients in CR1 who underwent unrelated bone marrow transplantation at 6 transplantation centers of the Nagoya Blood and Marrow Transplantation Group between 1993 and 2006. The median age of the 41 patients was 28 years (range, 18–51 years). HLA was matched in 33 transplants, with mismatches in 8 (HLA-A allele mismatch:1, HLA-DR serological mismatch: 2, HLA-DRB1 mismatch: 5). Leukemia-free survival (LFS) at 3 and 6 years from allo-SCT was 60.3 and 47.7%, respectively. LFS at 5 years was 62.1% for those transplanted from HLA-matched donors. LFS was significantly lower with HLA-mismatched donors due to higher transplantation-related mortality. Relapse was observed in 3 patients. Our study suggested that unrelated allo-SCT could improve LFS of patients with a potential graft-versus-leukemia effect. Unrelated allo-SCT for Ph(?) ALL patients in CR1 could be more beneficial by reducing TRM, such as selecting a HLA-matched donor. |
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