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Adult ALL

Risk assessment in adult acute lymphoblastic leukaemia before early haemopoietic stem cell transplantation with a geno-identical donor: an easy clinical prognostic score to identify patients who benefit most from allogeneic haemopoietic stem cell transplantation

Leukemia volume 17, pages 1596–1599 (2003)Cite this article

Abstract

In 1402 patients allografted in Europe during the period 1990–2000 with an HLA-identical sibling in first remission (CR1), the median interval from CR1 to allotransplant (96 days) was a major prognostic factor, patients transplanted earlier having a worse outcome. We studied in depth the 414 fully evaluable patients transplanted less than 96 days after achieving CR1; in these patients, only three factors predicted for the outcome by multivariate analysis: patient age, CR1 achievement with one or more induction courses and the recipient/donor sex combination. These three factors overcame the information from cytogenetics and source of stem cells. Three prognostic groups could be identified in relation to the outcome, using a prognostic score affecting 1 to each poor risk factor (total from 0 to 3): Group 1 (good prognosis) includes patients <35 years old, achieving CR1 with one induction course and to be transplanted with any other sex combination than female to male (score 0); group 2 (intermediate) with one adverse factor (score 1); and group 3 (bad prognosis) with two or three adverse criteria (scores 2 and 3). In these three groups, the 3-year leukaemia-free survival was 56±5%, 48±4% and 29±4% and the overall survival was 65±5, 53±4 and 29±5%, respectively. Therefore, adult patients with ALL and a score of 0 or 1 are good candidates for an early transplant if they have an identical sibling donor. Patient age, response to induction and the sex of the HLA-identical family donor (if existing) are the strongest easy predictors of the outcome for an early transplant in an adult patient with ALL. No additional information is mandatory.

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Authors and Affiliations

  1. Centre International Greffes de Moelle, European data management office of the EBMT, Hopital Saint-Antoine, Paris, France

    N-C Gorin, M Labopin, E Polge & F Frassoni

  2. Centre de Recherche Claude Bernard sur la Thérapie Cellulaire, Université Paris 6, Paris, France

    N-C Gorin, M Labopin, E Polge & F Frassoni

  3. Hopital Saint-Antoine, Paris, France

    N-C Gorin

  4. Hopital Henri Mondor, Creteil, France

    C Cordonnier

  5. Hopital Claude Huriez, Lille, France

    J P Jouet

  6. Hopital Edouard Herriot, Lyon, France

    M Michallet

  7. Centre Paoli Calmettes, Marseille, France

    D Blaise

  8. Hopital Haut-leveque, Pessac, France

    J Reiffers

  9. Hotel Dieu, Paris, France

    B Rio

  10. Hotel Dieu, Nantes, France

    N Milpied

  11. Ospedale San Martino, Genova, Italy

    F Frassoni

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  1. N-C Gorin
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on behalf of the Acute Leukaemia Working Party of the European Cooperative Group for Blood and Marrow Transplantation (EBMT)

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Supported in part by EBMT funds, Association Claude Bernard and Association pour la recherche sur le cancer (ARC).

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Gorin, NC., Labopin, M., Polge, E. et al. Risk assessment in adult acute lymphoblastic leukaemia before early haemopoietic stem cell transplantation with a geno-identical donor: an easy clinical prognostic score to identify patients who benefit most from allogeneic haemopoietic stem cell transplantation. Leukemia 17, 1596–1599 (2003). https://doi.org/10.1038/sj.leu.2403030

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  • DOI: https://doi.org/10.1038/sj.leu.2403030

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