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Acute Leukemia

Haploidentical hematopoietic SCT may be superior to conventional consolidation/maintenance chemotherapy as post-remission therapy for high-risk adult ALL

Bone Marrow Transplantation volume 50, pages 20–25 (2015)Cite this article

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Abstract

Only 30% of high-risk adult ALL patients in their first complete remission (CR1) are able to receive an HLA-matched sibling stem cell transplant. The role of haploidentical hematopoietic SCT (haplo-HSCT) in post-remission therapy is not well established. Recently, we developed a novel protocol for unmanipulated haploidentical transplantation. In this study, we compared haplo-HSCT with conventional consolidation and maintenance chemotherapy in adult high-risk ALL patients. Between January 2000 and December 2012, 104 patients received conventional chemotherapy and 79 patients received haplo-HSCT. Patients who underwent haplo-HSCT had significantly improved 3-year OS (72.5% vs 26.6%; P<0.001), 3-year disease-free survival (DFS) (63.9% vs 21.1%; P<0.001) and 3-year relapse (18.7% vs 60.5%; P<0.001) rates. The non-relapse mortality (NRM) rate was not different between patients treated with haplo-HSCT vs chemotherapy (19.2% vs 14.4%; P=0.80). In multivariate analysis, the only factor associated with improved OS, better DFS and low risk of relapse was haplo-HSCT. The only factor associated with high NRM was enrollment before 2006. In conclusion, haplo-HSCT may be an option for adults with high-risk ALL in CR1 who do not have an HLA-matched donor.

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Acknowledgements

We thank Editage (www.editage.cn) for their assistance in editing this manuscript.

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  1. Y-q Sun and J Wang: These authors contributed equally to this work.

Authors and Affiliations

  1. Peking University People’s Hospital, Peking University Institute of Hematology, Beijing, China

    Y-q Sun, J Wang, Q Jiang, L-p Xu, D-h Liu, X-h Zhang, K-y Liu & X-j Huang

  2. Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation for the Treatment of Hematological Diseases, Beijing, China

    Y-q Sun, J Wang, Q Jiang, L-p Xu, D-h Liu, X-h Zhang, K-y Liu & X-j Huang

  3. Peking-Tsinghua Center for Life Sciences, Beijing, China

    X-j Huang

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  1. Y-q Sun
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Correspondence to X-j Huang.

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Sun, Yq., Wang, J., Jiang, Q. et al. Haploidentical hematopoietic SCT may be superior to conventional consolidation/maintenance chemotherapy as post-remission therapy for high-risk adult ALL. Bone Marrow Transplant 50, 20–25 (2015). https://doi.org/10.1038/bmt.2014.195

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