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. 2013 Feb;19(2):208-13.
doi: 10.1016/j.bbmt.2012.09.003. Epub 2012 Sep 13.

T cell-depleted stem cell transplantation for adults with high-risk acute lymphoblastic leukemia: long-term survival for patients in first complete remission with a decreased risk of graft-versus-host disease

Jenna D Goldberg  1 , Alex Linker, Deborah Kuk, Ravin Ratan, Joseph Jurcic, Juliet N Barker, Hugo Castro-Malaspina, Sergio Giralt, Katharine Hsu, Ann A Jakubowski, Robert Jenq, Guenther Koehne, Esperanza B Papadopoulos, Marcel R M van den Brink, James W Young, Farid Boulad, Nancy A Kernan, Richard J O'Reilly, Susan E Prockop, Joachim Yahalom, Glenn Heller, Miguel-Angel Perales
Affiliations

T cell-depleted stem cell transplantation for adults with high-risk acute lymphoblastic leukemia: long-term survival for patients in first complete remission with a decreased risk of graft-versus-host disease

Jenna D Goldberg et al. Biol Blood Marrow Transplant. 2013 Feb.

Abstract

Consolidation with allogeneic hematopoietic stem cell transplantation (allo-HSCT) provides a survival benefit to patients with acute lymphoblastic leukemia (ALL). We have previously reported comparable survival and relapse rates after T cell-depleted (TCD) allo-HSCT compared with unmodified transplantations for acute myelogenous leukemia, myelodysplastic syndrome, and non-Hodgkin lymphoma with significantly decreased graft-versus-host disease (GVHD). We performed a 56-patient retrospective study to evaluate TCD allo-HSCT for the treatment of ALL after myeloablative total body irradiation-based therapy. The 2-year and 5-year overall survival rates for patients with ALL after TCD allo-HSCT were 0.39 (95% confidence interval [CI], 0.26-0.52) and 0.32 (95% CI, 0.19-0.44), respectively, and the 2-year and 5-year disease-free survival rates were 0.38 (95% CI, 0.25-0.50) and 0.32 (95% CI, 0.20-0.44). There was a trend toward improved survival of patients who underwent TCD allo-HSCT in first complete remission compared with those who did so in other remission states. The cumulative incidence of grade II-IV acute GVHD at 1 year was 0.20 (95% CI, 0.10-0.31), and no patients developed grade IV acute GVHD. The cumulative incidence of chronic GVHD in 41 evaluable patients at 2 and 5 years was 0.15 (95% CI, 0.04-0.26), and that of extensive chronic GVHD at 2 and 5 years was 0.05 (95% CI, 0-11.6). We demonstrate OS and DFS rates that compare favorably to unmodified allo-HSCT with lower rates of GVHD.

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Figures

Figure 1
Figure 1
a: Cumulative incidence of aGVHD b: Cumulative incidence of cGVHD
Figure 1
Figure 1
a: Cumulative incidence of aGVHD b: Cumulative incidence of cGVHD
Figure 2
Figure 2
a: Disease free survival for entire cohort b: Overall survival for entire cohort c: Disease free survival by disease status d: Overall survival by disease status
Figure 2
Figure 2
a: Disease free survival for entire cohort b: Overall survival for entire cohort c: Disease free survival by disease status d: Overall survival by disease status
Figure 2
Figure 2
a: Disease free survival for entire cohort b: Overall survival for entire cohort c: Disease free survival by disease status d: Overall survival by disease status
Figure 2
Figure 2
a: Disease free survival for entire cohort b: Overall survival for entire cohort c: Disease free survival by disease status d: Overall survival by disease status
See this image and copyright information in PMC

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