Erschienen in:
30.07.2021 | Original Article
Optimal treatment for Philadelphia-negative acute lymphoblastic leukemia in first remission in the era of high-intensity chemotherapy
verfasst von:
Shinichi Kako, Fumihiko Hayakawa, Kiyotoshi Imai, Junji Tanaka, Shuichi Mizuta, Satoshi Nishiwaki, Heiwa Kanamori, Junichi Mukae, Yukiyasu Ozawa, Tadakazu Kondo, Takahiro Fukuda, Tatsuo Ichinohe, Shuichi Ota, Yoshinori Tanaka, Tohru Murayama, Shingo Kurahashi, Toru Sakura, Noriko Usui, Shigeki Ohtake, Hitoshi Kiyoi, Itaru Matsumura, Yasushi Miyazaki, Yoshiko Atsuta
Erschienen in:
International Journal of Hematology
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Ausgabe 5/2021
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Abstract
The optimal treatment for Philadelphia chromosome (Ph)-negative acute lymphoblastic leukemia (ALL) in first complete remission (CR1) has not been established in the high-intensity chemotherapy era. The outcomes of patients with Ph-negative ALL who underwent allogeneic hematopoietic stem cell transplantation (HSCT) from a human leukocyte antigen-matched related or unrelated donor in CR1 (HSCT-MRD group and HSCT-MUD group) were obtained from a Japanese registry database. Patients aged 16–24 years and 25–65 years were analyzed separately, and their outcomes were compared to those of patients who continued high-intensity chemotherapy in CR1 in studies (202U group and 202O group) by the Japan Adult Leukemia Study Group (JALSG). In the HSCT-MRD group, patients younger than 25 years had lower overall survival (OS) than the 202U group, presumably due to the higher non-relapse mortality (NRM) in the HSCT-MRD group. Patients 25 years and older had similar OS to the 202O group. The lower relapse rate was counterbalanced by higher NRM in the HSCT-MRD group. In the HSCT-MUD group, patients in both age groups had similar OS to their corresponding groups in the JALSG studies. In conclusion, high-intensity chemotherapy may change the role of HSCT for Ph-negative ALL.