Utility of allogeneic stem cell transplantation for adult Ph+ALL with complete molecular remission
© 2024 Wiley Periodicals LLC..
This study aimed to investigate the usefulness of allogeneic stem cell transplantation (allo-SCT) for Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ALL) in the first complete remission (CR1) with complete molecular remission (CMR). We compared the outcomes between Ph+ALL patients who did or did not undergo allo-SCT in CR1. We included patients enrolled in the prospective clinical studies in the tyrosine kinase inhibitor era conducted by the Japan Adult Leukemia Study Group, who achieved CMR within 3 months. A total of 147 patients (allo-SCT: 101; non-SCT: 46) were eligible for this analysis. In the multivariate analyses, allo-SCT was significantly associated with both superior overall survival (OS) (adjusted hazard ratio (aHR): 0.54; 95% CI: 0.30-0.97; p = .04) and relapse-free survival (RFS) (aHR: 0.21; 95% CI: 0.12-0.38; p < .001). The 5-year adjusted OS and RFS were 73% and 70% in the allo-SCT cohort, whereas they were 50% and 20% in the non-SCT cohort. Despite the higher non-relapse mortality (aHR: 3.49; 95% CI: 1.17-10.4; p = .03), allo-SCT was significantly associated with a lower relapse rate (aHR: 0.10; 95% CI: 0.05-0.20; p < .001). In addition, allo-SCT was also associated with superior graft-versus-host disease-free, relapse-free survival (aHR: 0.43; 95% CI: 0.25-0.74; p = .002). Propensity score-matched analyses confirmed the results of the multivariate analyses. In patients who achieved CMR within 3 months, allo-SCT in CR1 had superior survival and lower relapse compared with the non-SCT cohort.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:99 |
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| Enthalten in: |
American journal of hematology - 99(2024), 5 vom: 28. Apr., Seite 806-815 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Nishiwaki, Satoshi [VerfasserIn] |
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| Links: |
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| Themen: |
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| Anmerkungen: |
Date Completed 09.04.2024 Date Revised 09.04.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1002/ajh.27237 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 520 | |a This study aimed to investigate the usefulness of allogeneic stem cell transplantation (allo-SCT) for Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ALL) in the first complete remission (CR1) with complete molecular remission (CMR). We compared the outcomes between Ph+ALL patients who did or did not undergo allo-SCT in CR1. We included patients enrolled in the prospective clinical studies in the tyrosine kinase inhibitor era conducted by the Japan Adult Leukemia Study Group, who achieved CMR within 3 months. A total of 147 patients (allo-SCT: 101; non-SCT: 46) were eligible for this analysis. In the multivariate analyses, allo-SCT was significantly associated with both superior overall survival (OS) (adjusted hazard ratio (aHR): 0.54; 95% CI: 0.30-0.97; p = .04) and relapse-free survival (RFS) (aHR: 0.21; 95% CI: 0.12-0.38; p < .001). The 5-year adjusted OS and RFS were 73% and 70% in the allo-SCT cohort, whereas they were 50% and 20% in the non-SCT cohort. Despite the higher non-relapse mortality (aHR: 3.49; 95% CI: 1.17-10.4; p = .03), allo-SCT was significantly associated with a lower relapse rate (aHR: 0.10; 95% CI: 0.05-0.20; p < .001). In addition, allo-SCT was also associated with superior graft-versus-host disease-free, relapse-free survival (aHR: 0.43; 95% CI: 0.25-0.74; p = .002). Propensity score-matched analyses confirmed the results of the multivariate analyses. In patients who achieved CMR within 3 months, allo-SCT in CR1 had superior survival and lower relapse compared with the non-SCT cohort | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Sugiura, Isamu |e verfasserin |4 aut | |
| 700 | 1 | |a Fujisawa, Shin |e verfasserin |4 aut | |
| 700 | 1 | |a Hatta, Yoshihiro |e verfasserin |4 aut | |
| 700 | 1 | |a Atsuta, Yoshiko |e verfasserin |4 aut | |
| 700 | 1 | |a Doki, Noriko |e verfasserin |4 aut | |
| 700 | 1 | |a Kurahashi, Shingo |e verfasserin |4 aut | |
| 700 | 1 | |a Ueda, Yasunori |e verfasserin |4 aut | |
| 700 | 1 | |a Dobashi, Nobuaki |e verfasserin |4 aut | |
| 700 | 1 | |a Maeda, Tomoya |e verfasserin |4 aut | |
| 700 | 1 | |a Matsumura, Itaru |e verfasserin |4 aut | |
| 700 | 1 | |a Tanaka, Masatsugu |e verfasserin |4 aut | |
| 700 | 1 | |a Kako, Shinichi |e verfasserin |4 aut | |
| 700 | 1 | |a Ichinohe, Tatsuo |e verfasserin |4 aut | |
| 700 | 1 | |a Fukuda, Takahiro |e verfasserin |4 aut | |
| 700 | 1 | |a Ohtake, Shigeki |e verfasserin |4 aut | |
| 700 | 1 | |a Ishikawa, Yuichi |e verfasserin |4 aut | |
| 700 | 1 | |a Miyazaki, Yasushi |e verfasserin |4 aut | |
| 700 | 1 | |a Kiyoi, Hitoshi |e verfasserin |4 aut | |
| 700 | 0 | |a Japan Adult Leukemia Study Group |e verfasserin |4 aut | |
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