Allogeneic Stem Cell Transplantation for Acute Lymphoblastic Leukemia in Adolescents and Young Adults

被引：20

作者：

Hangai, Mayumi ^{[1
,2
]}

Urayama, Kevin Y. ^{[1
,3
]}

Tanaka, Junji ^{[4
]}

Kato, Koji ^{[5
]}

Nishiwaki, Satoshi ^{[6
]}

Koh, Katsuyoshi ^{[7
]}

Noguchi, Maiko ^{[8
]}

Kato, Keisuke ^{[9
]}

Yoshida, Nao ^{[10
]}

Sato, Maho ^{[11
]}

Goto, Hiroaki ^{[12
]}

Yuza, Yuki ^{[13
]}

Hashii, Yoshiko ^{[14
]}

Atsuta, Yoshiko ^{[15
,16
]}

Mizuta, Shuichi ^{[17
]}

Kato, Motohiro ^{[18
,19
]}

机构：

[1] Natl Ctr Child Hlth & Dev, Dept Social Med, Tokyo, Japan

[2] Univ Tokyo, Dept Pediat, Tokyo, Japan

[3] St Lukes Int Univ, Grad Sch Publ Hlth, Tokyo, Japan

[4] Tokyo Womens Med Univ, Dept Hematol, Tokyo, Japan

[5] Cent Japan Cord Blood Bank, Seto, Japan

[6] Nagoya Univ Hosp, Dept Adv Med, Nagoya, Aichi, Japan

[7] Saitama Childrens Med Ctr, Dept Hematol Oncol, Saitama, Japan

[8] Natl Kyusyu Canc Ctr, Dept Pediat, Fukuoka, Fukuoka, Japan

[9] Ibaraki Childrens Hosp, Div Pediat Hematol & Oncol, Mito, Ibaraki, Japan

[10] Japanese Red Cross Nagoya First Hosp, Dept Hematol & Oncol, Childrens Med Ctr, Nagoya, Aichi, Japan

[11] Osaka Womens & Childrens Hosp, Dept Hematol Oncol, Izumi, Japan

[12] Kanagawa Childrens Med Ctr, Div Hematol Oncol, Yokohama, Kanagawa, Japan

[13] Tokyo Metropolitan Childrens Med Ctr, Dept Hematol Oncol, Fuchu, Tokyo, Japan

[14] Osaka Univ, Dept Pediat, Grad Sch Med, Suita, Osaka, Japan

[15] Japanese Data Ctr Hematopoiet Cell Transplantat, Nagoya, Aichi, Japan

[16] Nagoya Univ, Dept Healthcare Adm, Grad Sch Med, Nagoya, Aichi, Japan

[17] Kanazawa Med Univ, Dept Hematol & Immunol, Kanazawa, Ishikawa, Japan

[18] Natl Ctr Child Hlth & Dev, Childrens Canc Ctr, Tokyo, Japan

[19] Natl Ctr Child Hlth & Dev, Dept Pediat Hematol & Oncol Res, Tokyo, Japan

来源：

BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION | 2019年 / 25卷 / 08期

关键词：

Acute lymphoblastic leukemia; Adolescent and young adult; Hematologic stem cell transplantation;

D O I：

10.1016/j.bbmt.2019.04.014

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Hematologic stem cell transplantation (HSCT) is the most potent consolidation therapy for high-risk acute lymphoblastic leukemia (ALL), but their outcomes and complications in adolescent and young adult (AYA) patients remain unclear. We compared outcomes after HSCT for ALL among children (age 1 to 9 years; n = 607), adolescents (age 10 to 19 years; n = 783), and young adults (age 20 to 29 years old, n = 603), based on Japanese nationwide registry data. The 5-year overall survival (OS) rate among AYA patients was worse than that of children, at 64% (95% confidence interval lob 60% to 68%). In the AYA, the 5-year treatment-related mortality (TRM) after HSCT was 19% (95% CI, 16% to 22%), significantly higher than that in younger patients. The most common cause of TRM in the AYA was infection. The relapse rate was not different across the 3 age groups. When focusing on older adolescents (age 15 to 19 years), there was no difference in outcomes between those treated in pediatric centers and those treated in adult centers. In conclusion, the AYA had a greater risk of nonrelapse death than younger patients, and infection was the most common cause. Further optimization is required for HSCT in AYAs with ALL. (C) 2019 American Society for Blood and Marrow Transplantation.

引用

页码：1597 / 1602

页数：6

共 14 条

[1] Introduction of Transplant Registry Unified Management Program 2 (TRUMP2): scripts for TRUMP data analyses, part I (variables other than HLA-related data) [J].