Pretransplant Consolidation Is Not Beneficial for Adults with ALL Undergoing Myeloablative Allogeneic Transplantation

被引：6

作者：

Bejanyan, Nelli ^{[1
]}

Zhang, Mei-Jie ^{[2
,3
]}

Wang, Hai-Lin ^{[3
]}

Lazaryan, Aleksandr ^{[1
]}

de Lima, Marcos ^{[4
]}

Marks, David I. ^{[5
]}

Sandmaier, Brenda M. ^{[6
,7
]}

Bachanova, Veronika ^{[1
]}

Rowe, Jacob ^{[8
]}

Tallman, Martin ^{[9
]}

Kebriaei, Partow ^{[10
]}

Kharfan-Dabaja, Mohamed ^{[11
]}

Gale, Robert Peter ^{[12
]}

Lazarus, Hillard M. ^{[13
]}

Ustun, Celalettin ^{[1
]}

Copelan, Edward ^{[14
]}

Hamilton, Betty Ky ^{[15
]}

Schiller, Gary ^{[16
]}

Hogan, William ^{[17
,18
]}

Hashmi, Shahrukh ^{[19
,20
]}

Seftel, Matthew ^{[21
]}

Kanakry, Christopher G. ^{[22
]}

Olsson, Richard F. ^{[23
,24
]}

Martino, Rodrigo ^{[25
]}

Saber, Wael ^{[3
]}

Khoury, H. Jean ^{[26
]}

Weisdorf, Daniel J. ^{[1
]}

机构：

[1] Univ Minnesota, Div Hematol Oncol & Transplantat, 420 Delaware St SE,Mayo Mail Code 480, Minneapolis, MN 55455 USA

[2] Med Coll Wisconsin, Inst Hlth & Soc, Div Biostat, Milwaukee, WI 53226 USA

[3] Med Coll Wisconsin, Dept Med, CIBMTR Ctr Int Blood & Marrrow Trasnsplantat, Milwaukee, WI 53226 USA

[4] Univ Hosp Case Med Ctr, Seidman Canc Ctr, Dept Med, Cleveland, OH USA

[5] Univ Hosp Bristol NHS Trust, Adult Bone Marrow Transplant, Bristol, Avon, England

[6] Univ Washington, Div Med Oncol, Seattle, WA 98195 USA

[7] Fred Hutchinson Canc Res Ctr, Div Clin Res, 1124 Columbia St, Seattle, WA 98104 USA

[8] Shaare Zedek Med Ctr, Dept Hematol, Jerusalem, Israel

[9] Mem Sloan Kettering Canc Ctr, Dept Med, Leukemia Serv, 1275 York Ave, New York, NY 10021 USA

[10] Univ Texas MD Anderson Canc Ctr, Div Canc Med, Dept Stem Cell Transplantat, Houston, TX 77030 USA

[11] H Lee Moffitt Canc Ctr & Res Inst, Dept Blood & Marrow Transplantat, Tampa, FL USA

[12] Imperial Coll London, Div Expt Med, Dept Med, Hematol Res Ctr, London, England

[13] Univ Hosp Cleveland Med Ctr, Seidman Canc Ctr, Cleveland, OH USA

[14] Carolinas HealthCare Syst, Levine Canc Inst, Dept Hematol Oncol & Blood Disorders, Charlotte, NC USA

[15] Cleveland Clin, Taussig Canc Inst, Blood & Marrow Transplant Program, Cleveland, OH 44106 USA

[16] Univ Calif Los Angeles, David Geffen Sch Med, Hematol Malignancy Stem Cell Transplant Program, Los Angeles, CA 90095 USA

[17] Mayo Clin Rochester, Dept Hematol, Rochester, MN USA

[18] Mayo Clin Rochester, Transplant Ctr, Rochester, MN USA

[19] Mayo Clin, Dept Internal Med, Rochester, MN USA

[20] King Faisal Specialist Hosp & Res Ctr, Ctr Oncol, Riyadh, Saudi Arabia

[21] CancerCare Manitoba, Dept Med Oncol & Hematol, Winnipeg, MB, Canada

[22] NCI, Expt Transplantat & Immunol Branch, Ctr Canc Res, NIH, Bethesda, MD 20892 USA

[23] Karolinska Inst, Dept Lab Med, Div Therapeut Immunol, Stockholm, Sweden

[24] Uppsala Univ, Ctr Clin Res Sormland, Uppsala, Sweden

[25] Hosp Santa Creu & Sant Pau, Div Clin Hematol, Barcelona, Spain

[26] Emory Univ Hosp, 1364 Clifton Rd NE, Atlanta, GA 30322 USA

来源：

BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION | 2018年 / 24卷 / 05期

关键词：

ALL; Consolidation chemotherapy; Myeloablative.conditioning; Allogeneic transplant; ACUTE LYMPHOBLASTIC-LEUKEMIA; MINIMAL RESIDUAL DISEASE; STEM-CELL TRANSPLANTATION; 1ST COMPLETE REMISSION; BONE-MARROW-TRANSPLANTATION; TERM-FOLLOW-UP; GROUP-B; RETROSPECTIVE ANALYSIS; REDUCED-INTENSITY; LALA-94; TRIAL;

D O I：

10.1016/j.bbmt.2017.12.784

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Allogeneic hematopoietic cell transplantation (alloHCT) is curative for patients with acute lymphoblastic leukemia (ALL) who achieve complete remission (CR1) with chemotherapy. However, the benefit of consolidation chemotherapy remains uncertain in patients undergoing alloHCT. We compared clinical outcomes of 524 adult patients with ALL in CR1 who received >2 (n = 109), 1 (n = 93), or 0 cycles (n = 322) of consolidation before myeloablative alloHCT from 2008 to 2012. As expected, time to alloHCT was longer with increasing cycles of consolidation. Patients receiving 1, or 0 cycles of consolidation had an adjusted 3-year cumulative incidence of relapse of 20%, 27%, and 22%; 1-year transplant-related mortality (TRM) of 16%, 18%, and 23%; adjusted 3-year leukemia-free survival (LFS) of 54%, 48%, and 47%; and 3-year overall survival (OS) of 63%, 59%, and 54% (all P values >.40). Multivariable analysis confirmed that consolidation was not prognostic for LFS (relative risk, 1.20, 95% confidence interval,.86 to 1.67; P=.28 for no consolidation; RR, 1.18, 95% confidence interval,.79 to 1.76; P=.41 for 1 cycle versus.>:2 cycles = reference). Similarly, consolidation was not associated with OS, relapse, TRM, or graft-versus-host disease. We conclude that consolidation chemotherapy does not appear to provide added benefit in adult ALL patients with available donors who undergo myeloablative alloHCT in CR1. (C) 2017 American Society for Blood and Marrow Transplantation.

引用

页码：945 / 955

页数：11

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