Allogeneic Hematopoietic Stem Cell Transplantation in Adult Acute Lymphocytic Leukemia: Impact of Donor Source on Survival

Abstract Abstract 4555 Objective To compare the effect of the hematopoietic stem cell transplantation with and without imatinib to treat adult patients sufferred from Philadelphia chromosome-positive acute lymphocytic leukemia by evaluating the survival post-transplantation and the quality of life. Method 35 acute lymphocytic leukemia patients with Philadelphia chromosome-positive have taken hematopoietic stem cell transplantation between 2003 and 2011, in which 23 cases who were treated combined with imatinib were conducted in imatinib group, and the rest cases who haven't utilized imatinib were conducted in the control group. The incidence of relapse, incidence of graft-versus-host disease (GVHD), overall survival (OS) and disease-free survival (DFS) of the groups were compared so as to identify the advantage of combining treatment. Results The age, gender, cytogenetic classification, doner type, preparative regimen and counts of stem cells were comparative between the two groups. The proportion of patients who were in the first remission (CR1) in the imatinib group was higher than that in control group, however, the single factor analysis showed that it didn't affect the survival significantly. The incidences of relapse were 17.4% in the imatinib group and 16.7% in the control group (P = 0.9569), and the incidences of acute GVHD of Grade II to Grade IV were 35.3% and 41.7% (P = 0.4506), respectively. The 2-year-OS of two groups showed statistical difference of 62.6% versus 41.7% (P = 0.028), and 2-year-DFS were 53.7% and 33.3% (P = 0.054), respectively. Patients who survived more than 2 years post-transplantation would have a favorable prognosis. Conclusion Patients of imatinib group had a better survival, but the incidences of relapses and severe GVHD between the two groups had no significant difference. Thus, patients of Philadelphia chromosome-positive acute lymphocytic leukemia may benefit from the combination of hematopoietic stem cell transplantation and imatinib. Disclosures: No relevant conflicts of interest to declare.

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Transplantation for 37cases of Refractory Acute Lymphocytic Leukemia.

Blood ◽

10.1182/blood.v108.11.5365.5365 ◽

2006 ◽

Vol 108 (11) ◽

pp. 5365-5365

Author(s):

Xiao Ma ◽

De Pei Wu ◽

Ai - Ning Su

Keyword(s):

Stem Cell ◽

Hematopoietic Stem Cell Transplantation ◽

Stem Cell Transplantation ◽

Cell Transplantation ◽

Hematopoietic Stem Cell ◽

Acute Lymphocytic Leukemia ◽

Acute Gvhd ◽

Lymphocytic Leukemia ◽

Hematopoietic Stem ◽

Fatal Infection

Abstract Objective: To explore the efficiency and toxicity of allo-geneic hematopoietic stem cell transplantation (Allo-HSCT) for refractory acute lymphocytic leukemia. Patients and Methods: Thirty-seven patients of refractory acute lymphocytic leukemia received allo-geneic hematopoietic stem cell transplantation containing 18/37 cases from HLA-identical siblings donors, 8/37 cases from HLA-identical unrelated donors and 11/37 cases from haplo-identical donors of the mother. The tolerance, transplant related complications, survival rate were observed and analyzed. A myeloablative conditioning regimen included TBI and Cyclophosphamide. Cyclosporine A combined MTX were used to prevent graft versus host disease (GVHD) and G-CSF was administered after Allo-HSCT. Result: All 37 patients tolerated the therapy well and Slight or moderate mucositis was happened. Nineteen patients had light abnormal liver function and two had renal disfunction lightly, one patient had epilepsy during the therapy. Fatal infection complications were occurred in 6 patients (including idiopathic pneumonia in 2 patients). Severe acute GVHD was presented in 5 patients. Chronic GVHD was occurred in 16 patients. Hemorrhagic cystitis was happened in 1 patient, and 9 patients relapsed again after transplantation. Venoocclusive liver disease, host versus graft disease, substantia alba encephalopathy, fatal hemorrhage, secondary tumor and dysphrenia were not occured. Hematopoietic reconstitution obtained on days 12 to 25(day 17 on average). In the follow-up duration of 9 to 55 months (34 months of mid position), most of these patients had a complete chimerical state. Twenty of 37 patients are alive (54.1%). Disease free survival is 48.6%. Conclusion: Allo-HSCT is an effective therapy in the treatment of refractory acute lymphocytic leukemia. Relapse again after transplantation, fatal infection, and severe acute GVHD are the main reasons of failure.

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