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Nonmyeloablative stem cell transplantation in adults with high-risk ALL may be effective in early but not in advanced disease

Leukemia volume 16, pages 2423–2428 (2002)Cite this article

Abstract

The feasibility of nonmyeloablative stem cell transplantation (NST) was evaluated in 22 adults with high-risk ALL. 16/22 patients had advanced disease and 11/22 had Ph+ ALL. Eleven patients received NST as first stem cell transplantation (SCT). Eleven patients had relapses after allogeneic or autologous SCT and underwent a salvage NST. 18/22 patients (82%) engrafted after NST. 13/16 patients (81%) with active disease reached complete remission (CR). 11 of 13 patients developed GVHD. After first NST 10/11 patients (91%) engrafted. Six of seven patients with active disease reached CR. Three of five relapsing patients reached subsequent CR after donor lymphocyte infusions, termination of immunosuppression or imatinib. Three of 11 patients (27%) are alive in CR 5 to 30 months after NST. Eight of 11 patients have died, 3/8 from leukemia and 5/8 from transplant-related causes. After salvage NST, 8/11 patients (73%) engrafted. Seven of nine patients with active disease reached CR. Only one of 11 patients transplanted, who was in CR before undergoing salvage NST is alive 19 months after NST. Five of 11 have died from leukemia, one of 11 after graft failure and four of 11 from transplant-related causes. Four of 22 patients (18%) are alive in CR 5, 14, 19 and 30 months after NST. NST is feasible in adults with high risk ALL. However, transplant-related mortality remains high and only patients transplanted in CR seem to have long-term disease-free survival.

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Authors and Affiliations

  1. Medizinische Klinik mit Schwerpunkt Hämatologie und Onkologie, Universitätsklinikum Charitéz, Berlin, Germany

    R Arnold & G Massenkeil

  2. Medizinische Klinik und Poliklinik I, Carl-Gustav-Carus Universität, Dresden, Germany

    M Bornhäuser & G Ehninger

  3. Klinik und Poliklinik für Knochenmarktransplantation, Universitätsklinikum, Essen, Germany

    DW Beelen

  4. Klinik für Knochenmarktransplantation und Hämatologie/Onkologie, Idar-Oberstein, Germany

    AA Fauser

  5. Abteilung Hämatologie/Onkologie, Universität Leipzig, Germany

    U Hegenbart

  6. Abteilung Hämatologie und Onkologie, Medizinische Hochschule Hannover, Germany

    B Hertenstein

  7. Medizinische Klinik und Poliklinik V, Ruprecht-Karls-Universität Heidelberg, Germany

    AD Ho

  8. Medizinische Klinik III, Universitätsklinikum Benjamin Franklin, Berlin, Germany

    W Knauf

  9. Medizinische Klinik III, Klinikum Groβhadern, LMU, München, Germany

    HJ Kolb

  10. III Medizinische Klinik, Johannes Gutenberg Universität, Mainz, Germany

    K Kolbe

  11. Klinik für Innere Medizin II, Friedrich-Schiller-Universität Jena, Germany

    HG Sayer

  12. Deutsche Klinik für Diagnostik, Zentrum für Knochenmarktransplantation, Wiesbaden, Germany

    R Schwerdtfeger

  13. Institut für Medizinische Onkologie und Hämatologie, Klinikum Nürnberg, Germany

    H Wandt

  14. Medizinische Klinik III für Hämatologie, Universitätsklinikum Frankfurt, Germany

    D Hoelzer

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  1. R Arnold
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  2. G Massenkeil
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Arnold, R., Massenkeil, G., Bornhäuser, M. et al. Nonmyeloablative stem cell transplantation in adults with high-risk ALL may be effective in early but not in advanced disease. Leukemia 16, 2423–2428 (2002). https://doi.org/10.1038/sj.leu.2402712

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  • DOI: https://doi.org/10.1038/sj.leu.2402712

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