Effects of conditioning intensity in allogeneic stem cell transplantation for Philadelphia chromosome‑positive acute lymphoblastic leukemia

Int J Hematol. 2015 Dec;102(6):689-96. doi: 10.1007/s12185-015-1883-0.

Abstract

We retrospectively analyzed the outcomes of patients with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ALL) who underwent first allogeneic stem cell transplantation (allo-SCT) at complete remission (CR) with myeloablative conditioning (MAC, n = 31) or reduced-intensity conditioning (RIC, n = 15) between 2001 and 2012. All the patients had received tyrosine kinase inhibitor (TKI)-based chemotherapy prior to allo-SCT. Overall survival (OS) rates (57 vs 63%, p = 0.53), leukemia-free survival rates (50 vs 65%, p = 0.29), and non-relapse mortality rates (39 vs 35%, p = 0.62) at 2 years were similar between the MAC and RIC groups. The minimal residual disease (MRD) status evaluated by sensitive polymerase chain reaction prior to allo-SCT did not influence the OS rate (77 vs 54%, p = 0.28) and leukemia-free survival rate (69 vs 51%, p = 0.48), irrespective of the conditioning intensity. Our data suggest that the RIC regimen may represent a sufficient intensity of therapeutic pre-transplant conditioning for patients with Ph+ALL who have maintained a hematological CR with TKI-combined chemotherapy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Allografts
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Combined Modality Therapy
  • Dasatinib / administration & dosage
  • Female
  • Graft vs Host Disease / prevention & control
  • Humans
  • Imatinib Mesylate / administration & dosage
  • Male
  • Middle Aged
  • Philadelphia Chromosome*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / genetics*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy*
  • Protein Kinase Inhibitors / administration & dosage
  • Remission Induction
  • Retrospective Studies
  • Transplantation Conditioning / methods*
  • Treatment Outcome
  • Young Adult

Substances

  • Protein Kinase Inhibitors
  • Imatinib Mesylate
  • Dasatinib