Impact of transplant eligibility and availability of a human leukocyte antigen-identical matched related donor on outcome of older patients with acute lymphoblastic leukemia. Issue 10 (3rd October 2015)

• Record Type: Journal Article
• Authors: Barba, Pere; Martino, Rodrigo; Martinez-Cuadron, David; Olga, García; Esquirol, Albert; Gil-Cortés, Cristina; Gonzalez, José; Fernandez-Avilés, Francesc; Valcárcel, David; Guardia, Ramón; Duarte, Rafael F.; Hernandez-Rivas, Jesús Maria; Abella, Eugenia; Montesinos, Pau; Ribera, Josep Maria
• Is Part Of: Leukemia & lymphoma. Volume 56:Issue 10(2015:Oct.)
• Page Start: 2812
• Page End: 2818
• Publication Date: 2015-10-03
• Subjects: Allogeneic transplant -- acute lymphoblastic leukemia -- RIC -- HCT; Leukemia -- Periodicals; Lymphomas -- Periodicals; 616.99419
• DOI: 10.3109/10428194.2015.1014365
• Languages: English
• ISSNs: 1042-8194

Abstract

Abstract : The role of allogeneic hematopoietic cell transplant (allo-HCT) in elderly patients with acute lymphoblastic leukemia (ALL) is unclear. We conducted a prospective study including 110 homogeneously treated patients with ALL aged 50–70 years. Their outcomes were analyzed by intention-to-treat on a donor-versus-no donor basis. Fifty-five patients (50%) underwent human leukocyte antigen (HLA) typing and were considered potential allo-HCT candidates, although only 25 (23%) eventually received an allo-HCT. Among potential allo-HCT candidates, patients with ( n = 28) and without ( n = 27) an HLA-identical sibling showed similar leukemia-free survival, overall survival (OS) and relapse risk, and the only variable associated with a better outcome was achievement of first complete remission (CR1) after induction therapy. Among the 25 patients who actually received an allo-HCT, the 4-year non-relapse mortality and OS were 42% (95% confidence interval 31–53%) and 37% (95% confidence interval 27–47%), respectively. In conclusion, having an HLA-identical sibling donor was not associated with a better outcome in patients with ALL aged 50–70 years.