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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Change history
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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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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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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DOI: https://doi.org/10.1038/bmt.2013.140
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