Pediatric‐inspired therapy compared to allografting for Philadelphia chromosome‐negative adult ALL in first complete remission
Abstract
For adults with Philadelphia chromosome‐negative (Ph−) acute lymphoblastic leukemia (ALL) in first complete remission (CR1), allogeneic hematopoietic cell transplantation (HCT) is an established curative strategy. However, pediatric‐inspired chemotherapy may also offer durable leukemia‐free survival in the absence of HCT. We compared 422 HCT recipients aged 18–50 years with Ph‐ALL in CR1 reported to the CIBMTR with an age‐matched concurrent cohort of 108 Ph− ALL CR1 patients who received a Dana‐Farber Consortium pediatric‐inspired non‐HCT regimen. At 4 years of follow‐up, incidence of relapse after HCT was 24% (95% CI 19–28) versus 23% (95% CI 15–32) for the non‐HCT (chemo) cohort (P=0.97). Treatment‐related mortality (TRM) was higher in the HCT cohort [HCT 37% (95% CI 31–42) versus chemo 6% (95% CI 3–12), PPPP<0.0001]. For younger adults with Ph− ALL, pediatric‐inspired chemotherapy had lower TRM, no increase in relapse, and superior overall survival compared to HCT. Am. J. Hematol. 91:322–329, 2016. © 2015 Wiley Periodicals, Inc.
Document Details
- Document Type
- Pub Defense Publication
- Publication Date
- Feb 22, 2016
- Source ID
- 10.1002/ajh.24285
Entities
People
- Ann E. Woolfrey
- César O. Freytes
- Daniel J Weisdorf
- Daniel J. Deangelo
- Donna Neuberg
- For The Acute Leukemia Committee Of The Cibmtr And The Dana Farber All Consortium
- Hailin Wang
- Hillard M Lazarus
- Julie Bergeron
- Karen Kuhn Ballen
- Kristjan Paulson
- Martin S. Tallman
- Matthew D. Seftel
- Mehdi Hamadani
- Mei‐jie Zhang
- Mohamed A. Kharfan‐dabaja
- Robert Soiffer
- Stephen Couban
- Stephen E. Sallan
- Taiga Nishihori
- Wael Saber
Organizations
- CancerCare Manitoba
- Dalhousie University
- Dana–Farber Cancer Institute
- Fred Hutchinson Cancer Center
- H. Lee Moffitt Cancer Center & Research Institute
- Hôpital Maisonneuve-Rosemont
- Massachusetts General Hospital
- Medical College of Wisconsin
- Memorial Sloan Kettering Cancer Center
- National Cancer Institute
- National Heart, Lung, and Blood Institute
- National Institute of Allergy and Infectious Diseases
- Office of Naval Research
- UH Cleveland Medical Center
- University of Minnesota
- University of Texas at Austin