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Conditioning Regimens

Reduced-intensity allogeneic stem cell transplantation for patients aged 50 years or older with B-cell ALL in remission: a retrospective study by the Adult ALL Working Group of the Japan Society for Hematopoietic Cell Transplantation

Bone Marrow Transplantation volume 48, pages 1513–1518 (2013)Cite this article

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An Erratum to this article was published on 04 December 2013

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Abstract

We retrospectively assessed the outcome and pretransplantation predictors of the outcome in 118 patients aged ⩾50 years who received fludarabine-containing reduced-intensity allo-SCT (RIST) for B-cell ALL in the first or second CR. Eighty patients received transplants from unrelated donors. Seventy-eight patients were positive for the Ph chromosome. The median follow-up period was 18 months and the 2-year OS rate was 56%. The 2-year cumulative incidence of relapse and non-relapse mortality was 28% and 26%, respectively. The incidence of grades II–IV and III–IV acute GVHD was 46% and 24%, respectively. After 2 years, the incidence of chronic GVHD was 37%. Multivariate analysis of pretransplant factors showed that a higher white blood cell count (⩾30 × 109/L) at diagnosis (hazard ratio (HR)=2.19, P=0.007) and second CR (HR=2.02, P=0.036) were significantly associated with worse OS, whereas second CR (HR=3.83, P<0.001) and related donor (HR=2.34, P=0.039) were associated with a higher incidence of relapse. Fludarabine-containing RIST may be a promising strategy for older patients with B-cell ALL in their first remission.

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  • 04 December 2013

    This article has been corrected since Advance Online Publication and an erratum is also printed in this issue.

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Acknowledgements

We thank all of the staff from the participating institutions of the Japan Society for Hematopoietic Cell Transplantation for their assistance and cooperation.

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Authors and Affiliations

  1. Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan

    H Kanamori & M Tanaka

  2. Department of Hematology, Fujita Health University Hospital, Toyoake, Japan

    S Mizuta

  3. Division of Hematology, Saitama Medical Center, Jichi Medical University, Saitama, Japan

    S Kako

  4. Division of Molecular Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan

    H Kato

  5. Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan

    S Nishiwaki

  6. Department of Hematology, Sapporo Hokuyu Hospital, Sapporo, Japan

    K Imai

  7. Department of Hematology and Oncology, Hokkaido University Graduate School of Medicine, Sapporo, Japan

    A Shigematsu

  8. Department of Hematology, Osaka City University Graduate School of Medicine, Osaka, Japan

    H Nakamae

  9. Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan

    K Ikegame

  10. Third Department of Internal Medicine, Yamaguchi University School of Medicine, Ube, Japan

    T Yujiri

  11. Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan

    T Fukuda

  12. Division of Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan

    K Minagawa

  13. Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan

    T Eto

  14. Department of Cell Processing and Transfusion, Research Hospital, Institute of Medical Science, University of Tokyo, Tokyo, Japan

    T Nagamura-Inoue

  15. Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan

    Y Morishima

  16. Department of HSCT Data Management and Biostatistics, Nagoya University Graduate School of Medicine, Nagoya, Japan

    R Suzuki

  17. Division of Hematology, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan

    H Sakamaki

  18. Department of Hematology, Tokyo Women’s Medical University, Tokyo, Japan

    J Tanaka

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  1. H Kanamori
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  4. H Kato
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  8. H Nakamae
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  9. M Tanaka
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  12. T Fukuda
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  14. T Eto
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  15. T Nagamura-Inoue
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  16. Y Morishima
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  17. R Suzuki
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  18. H Sakamaki
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  19. J Tanaka
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Corresponding author

Correspondence to H Kanamori.

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The authors declare no conflict of interest.

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Author contributions

HK (Kanamori) designed the study, analyzed the data and wrote the draft version of this manuscript. HN, MT, KI, TY, TF, KM and TE submitted and cleaned the data; T-NI, YM, RS and HS collected and reviewed the data; And SM, SK, HK (Kato), SN, KI, AS and JT interpreted the results and critically revised the manuscript.

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Kanamori, H., Mizuta, S., Kako, S. et al. Reduced-intensity allogeneic stem cell transplantation for patients aged 50 years or older with B-cell ALL in remission: a retrospective study by the Adult ALL Working Group of the Japan Society for Hematopoietic Cell Transplantation. Bone Marrow Transplant 48, 1513–1518 (2013). https://doi.org/10.1038/bmt.2013.140

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