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Allografting

Myeloablative allogeneic hematopoietic stem cell transplantation for Philadelphia chromosome-positive acute lymphoblastic leukemia in adults: significant roles of total body irradiation and chronic graft-versus-host disease

Bone Marrow Transplantation volume 36, pages 867–872 (2005)Cite this article

Summary:

Disease-free survival in Philadelphia chromosome-positive ALL (Ph+ALL) is very poor, and allogeneic hematopoietic stem cell transplantation (allo-HSCT) is currently considered the only procedure with curative potential. To identify factors affecting transplant outcome, we analyzed the data from 197 Ph+ALL patients aged 16 years or older who had undergone allo-HSCT. The 5-year survival rates were 34% for patients in first complete remission (CR), 21% for those in second or subsequent CR, and 9% for those with active disease (P<0.0001). Multivariate analysis showed four pre-transplant factors as significantly associated with better survival: younger age, CR at the time of transplantation, conditioning with total body irradiation, and HLA-identical sibling donor (P<0.0001, P<0.0001, P=0.0301, P=0.0412, respectively). Severe acute GVHD increased the risk of treatment-related mortality (TRM) without diminishing the risk of relapse, whereas chronic GVHD reduced the risk of relapse without increasing the risk of TRM. Thus, patients who developed extensive chronic GVHD had better survivals (P=0.0217), and those who developed grade III–IV acute GVHD had worse survivals (P=0.0023) than did the others.

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Acknowledgements

This study was conducted as a project of Working Group 11 of the JSHCT. We thank all physicians and staff at the cooperating centers for contributing patient data.

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Authors and Affiliations

  1. Nagoya University Graduate School of Medicine, Nagoya, Japan

    M Yanada, T Naoe, Y Atsuta & K Yamamoto

  2. Meitetsu Hospital, Nagoya, Japan

    H Iida & H Sao

  3. Tokyo Metropolitan Komagome Hospital, Tokyo, Japan

    H Sakamaki

  4. Saiseikai Maebashi Hospital, Maebashi, Japan

    T Sakura

  5. Yokohama City University Hospital, Yokohama, Japan

    H Kanamori

  6. Japanese Red Cross Nagoya First Hospital, Nagoya, Japan

    Y Kodera

  7. Keio University School of Medicine, Tokyo, Japan

    S Okamoto

  8. University of Tokyo Hospital, Tokyo, Japan

    Y Kanda

  9. Jikei University Hospital, Tokyo, Japan

    O Asai

  10. Kansai Medical University, Osaka, Japan

    K Nakai

  11. Kanagawa Cancer Center, Yokohama, Japan

    A Maruta

  12. Tokai University School of Medicine, Isehara, Japan

    K Kishi

  13. Niigata University Medical & Dental Hospital, Niigata, Japan

    T Furukawa

  14. Hokkaido University Graduate School of Medicine, Sapporo, Japan

    J Tanaka

  15. Institute of Medical Science, University of Tokyo, Tokyo, Japan

    S Takahashi

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  1. M Yanada
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Correspondence to M Yanada.

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Yanada, M., Naoe, T., Iida, H. et al. Myeloablative allogeneic hematopoietic stem cell transplantation for Philadelphia chromosome-positive acute lymphoblastic leukemia in adults: significant roles of total body irradiation and chronic graft-versus-host disease. Bone Marrow Transplant 36, 867–872 (2005). https://doi.org/10.1038/sj.bmt.1705148

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  • DOI: https://doi.org/10.1038/sj.bmt.1705148

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