Title: Myeloablative allogeneic versus autologous stem cell transplantation in adult patients with acute lymphoblastic leukemia in first remission: a prospective sibling donor versus no-donor comparison
Authors: Cornelissen, Jan J
van der Holt, Bronno
Verhoef, Gregor ×
van't Veer, Mars B
van Oers, Marinus H J
Schouten, Harry C
Ossenkoppele, Gert
Sonneveld, Pieter
Maertens, Johan
van Marwijk Kooy, Marinus
Schaafsma, Martijn R
Wijermans, Pierre W
Biesma, Douwe H
Wittebol, Shulamit
Voogt, Paul J
Baars, Joke W
Zachee, Pierre
Verdonck, Leo F
Löwenberg, Bob
Dekker, Adriaan W #
Issue Date: Feb-2009
Publisher: W.B. Saunders
Series Title: Blood vol:113 issue:6 pages:1375-1382
Abstract: While commonly accepted in poor-risk acute lymphoblastic leukemia (ALL), the role of allogeneic hematopoietic stem cell transplantation (allo-SCT) is still disputed in adult patients with standard-risk ALL. We evaluated outcome of patients with ALL in first complete remission (CR1), according to a sibling donor versus no-donor comparison. Eligible patients (433) were entered in 2 consecutive, prospective studies, of whom 288 (67%) were younger than 55 years, in CR1, and eligible to receive consolidation by either an autologous SCT or an allo-SCT. Allo-SCT was performed in 91 of 96 patients with a compatible sibling donor. Cumulative incidences of relapse at 5 years were, respectively, 24 and 55% for patients with a donor versus those without a donor (hazard ratio [HR], 0.37; 0.23-0.60; P < .001). Nonrelapse mortality estimated 16% (+/- 4) at 5 years after allo-SCT. As a result, disease-free survival (DFS) at 5 years was significantly better in the donor group: 60 versus 42% in the no-donor group (HR: 0.60; 0.41-0.89; P = .01). After risk-group analysis, improved outcome was more pronounced in standard-risk patients with a donor, who experienced an overall survival of 69% at 5 years (P = .05). In conclusion, standard-risk ALL patients with a sibling donor may show favorable survival following SCT, due to both a strong reduction of relapse and a modest nonrelapse mortality. This trial is registered with under trial ID NTR228.
ISSN: 0006-4971
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Hematology Section (-)
Faculty of Medicine - miscellaneous
× corresponding author
# (joint) last author

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