Abstract |
The role of haploidentical related allogeneic hematopoietic stem cell transplantation (allo-HSCT) in Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph(+) ALL) is not clear. We aimed to investigate the long-term survival of Ph(+) ALL patients who underwent haploidentical donor (HID)-HSCT and to analyze the factors influencing relapse and survival after allo-HSCT. The study population included Ph(+) ALL patients who underwent haploidentical related allo-HSCT. Additionally, Ph(+) ALL patients who underwent HLA-matched related donor (MRD) transplants during the same period were included to compare outcomes. BCR-ABL transcript levels were analyzed by using real-time quantitative reverse transcription PCR. Clinical data from 139 Ph(+) ALL patients who received allo-HSCT in our center were analyzed. Of these patients, 101 received HID transplants and 38 received MRD transplants. At a median follow-up of 36 months, 5-year disease-free survival (DFS) and overall survival (OS) rates in the HID transplant group were 65.8% and 74.0%, respectively. The 5-year cumulative incidence of relapse (CIR) and nonrelapse mortality (NRM) rates for the HID transplant group were 20.3% and 15.6%, respectively. In addition, there were no differences in OS, DFS, CIR, and NRM between the HID and MRD groups. Multivariate analysis showed that imatinib resistance was a significant factor influencing DFS and CIR in HID transplant patients. Haploidentical HSCT for the treatment of Ph(+) ALL achieves promising long-term survival, which is comparable with that of HLA-MRD HSCT. Imatinib resistance is a negative predictor of relapse and DFS after allo-HSCT.
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Authors | Huan Chen, Kai-yan Liu, Lan-ping Xu, Yu-hong Chen, Wei Han, Xiao-hui Zhang, Yu Wang, Ya-zhen Qin, Yan-rong Liu, Xiao-jun Huang |
Journal | Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation
(Biol Blood Marrow Transplant)
Vol. 21
Issue 6
Pg. 1110-6
(Jun 2015)
ISSN: 1523-6536 [Electronic] United States |
PMID | 25698612
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2015. Published by Elsevier Inc. |
Chemical References |
- BCR-ABL1 fusion protein, human
- Immunosuppressive Agents
- Myeloablative Agonists
- Imatinib Mesylate
- Fusion Proteins, bcr-abl
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Topics |
- Acute Disease
- Adult
- Drug Resistance, Neoplasm
(genetics)
- Female
- Fusion Proteins, bcr-abl
(genetics, immunology)
- Gene Expression
- Graft vs Host Disease
(genetics, immunology, mortality, prevention & control)
- Haplotypes
- Hematopoietic Stem Cell Transplantation
- Humans
- Imatinib Mesylate
(therapeutic use)
- Immunosuppressive Agents
(therapeutic use)
- Male
- Middle Aged
- Myeloablative Agonists
(therapeutic use)
- Philadelphia Chromosome
- Precursor Cell Lymphoblastic Leukemia-Lymphoma
(genetics, immunology, mortality, therapy)
- Prognosis
- Prospective Studies
- Recurrence
- Siblings
- Survival Analysis
- Transplantation Conditioning
(methods)
- Transplantation, Homologous
- Unrelated Donors
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