Erschienen in:
14.02.2017 | Original Article
Allogeneic stem cell transplantation for adult patients with acute lymphoblastic leukemia who had central nervous system involvement: a study from the Adult ALL Working Group of the Japan Society for Hematopoietic Cell Transplantation
verfasst von:
Akio Shigematsu, Shinichi Kako, Kenjiro Mitsuhashi, Koji Iwato, Naoyuki Uchida, Yoshinobu Kanda, Takahiro Fukuda, Masashi Sawa, Yasushi Senoo, Hiroyasu Ogawa, Koichi Miyamura, Satoru Takada, Tokiko Nagamura-Inoue, Yasuo Morishima, Tatsuo Ichinohe, Yoshiko Atsuta, Shuichi Mizuta, Junji Tanaka
Erschienen in:
International Journal of Hematology
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Ausgabe 6/2017
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Abstract
The prognosis for adult acute lymphoblastic leukemia (ALL) patients with central nervous system (CNS) involvement (CNS+) who received allogeneic hematopoietic stem cell transplantation (allo-SCT) remains unclear. We retrospectively compared the outcomes of allo-SCT for patients with CNS involvement and for patients without CNS involvement (CNS−) using a database in Japan. The eligibility criteria for this study were as follows: diagnosis of ALL, aged more than 16 years, allo-SCT between 2005 and 2012, and first SCT. Data for 2582 patients including 136 CNS+ patients and 2446 CNS− patients were used for analyses. As compared with CNS− patients, CNS+ patients were younger, had worse disease status at SCT and had poorer performance status (PS) at SCT (P < 0.01). Incidence of relapse was higher in CNS+ patients (P = 0.02), and incidence of CNS relapse was also higher (P < 0.01). The probability of 3-year overall survival (OS) was better in CNS− patients (P < 0.01) by univariate analysis. However, in patients who received SCT in CR, there was no difference in the probability of OS between CNS+ and CNS− patients (P = 0.38) and CNS involvement did not have an unfavorable effect on OS by multivariate analysis. CNS+ patients who achieved CR showed OS comparable to that of CNS− patients.