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Acute Lymphoma

Allogeneic transplantation from HLA-matched sibling or partially HLA-mismatched related donors for primary refractory acute leukemia

Bone Marrow Transplantation volume 29, pages 291–295 (2002)Cite this article

Abstract

Allogeneic transplantation is successful in a minority of patients with primary refractory acute leukemia (PRAL). An HLA-matched sibling donor (MSD) is available only in 30–40% of the patients, whereas a partially mismatched related donor (PMRD) is available for most. We compared the outcome of 24 MSD (median age 24 years) and 19 PMRD (median age 34 years; P = 0.04) allograft recipients with PRAL. All MSD patients received non-T cell-depleted marrow whereas all PMRD patients received partially T cell-depleted marrow. All evaluable PMRD patients and 90% of the evaluable MSD patients attained CR. Six patients in each group with recurrent/persistent disease died. Ten PMRD (3-year probability 70%) and 14 MSD (3-year probability 63%) patients died of treatment-related causes. At the last follow-up, three PMRD (18–50 months; 3-year probability 14%) and four MSD (20–166 months; 3-year probability 20%) patients were alive and well. We conclude that allogeneic transplantation is a viable therapeutic option for PRAL. PMRD transplantation is a reasonable alternative in patients with no MSD, and results in similar outcome. In terms of identifying a donor and harvesting cells, a PMRD transplant is significantly quicker than an unrelated donor transplant – a point of great practical importance in the setting of failed induction chemotherapy where time is of the essence.

Bone Marrow Transplantation (2002) 29, 291–295. doi:10.1038/sj.bmt.1703373

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Authors and Affiliations

  1. Royal Marsden Hospital, Surrey, UK

    S Singhal, R Powles, J Treleaven, S Kulkarni, B Sirohi, CR Pinkerton, S Meller & J Mehta

  2. South Carolina Cancer Center, Columbia, SC, USA

    S Singhal, PJ Henslee-Downey, KY Chiang, K Godder, F van Rhee & J Mehta

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  1. S Singhal
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  2. R Powles
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  7. S Kulkarni
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Singhal, S., Powles, R., Henslee-Downey, P. et al. Allogeneic transplantation from HLA-matched sibling or partially HLA-mismatched related donors for primary refractory acute leukemia. Bone Marrow Transplant 29, 291–295 (2002). https://doi.org/10.1038/sj.bmt.1703373

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