Myeloablative allogeneic versus autologous stem cell transplantation in adult patients with acute lymphoblastic leukemia in first remission: a prospective sibling donor versus no-donor comparison
While commonly accepted in poor-risk acute lymphoblastic leukemia (ALL), the role of allogeneic hematopoietic stem cell transplantation (allo-SCT) is still disputed in adult patients with standard-risk ALL. We evaluated outcome of patients with ALL in first complete remission (CR1), according to a s...
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| Veröffentlicht in: | Blood 2009-02, Vol.113 (6), p.1375-1382 |
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| creator | Cornelissen, Jan J. van der Holt, Bronno Verhoef, Gregor E.G. van 't Veer, Mars B. van Oers, Marinus H.J. Schouten, Harry C. Ossenkoppele, Gert Sonneveld, Pieter Maertens, Johan van Marwijk Kooy, Marinus Schaafsma, Martijn R. Wijermans, Pierre W. Biesma, Douwe H. Wittebol, Shulamit Voogt, Paul J. Baars, Joke W. Zachée, Pierre Verdonck, Leo F. Löwenberg, Bob Dekker, Adriaan W. |
| description | While commonly accepted in poor-risk acute lymphoblastic leukemia (ALL), the role of allogeneic hematopoietic stem cell transplantation (allo-SCT) is still disputed in adult patients with standard-risk ALL. We evaluated outcome of patients with ALL in first complete remission (CR1), according to a sibling donor versus no-donor comparison. Eligible patients (433) were entered in 2 consecutive, prospective studies, of whom 288 (67%) were younger than 55 years, in CR1, and eligible to receive consolidation by either an autologous SCT or an allo-SCT. Allo-SCT was performed in 91 of 96 patients with a compatible sibling donor. Cumulative incidences of relapse at 5 years were, respectively, 24 and 55% for patients with a donor versus those without a donor (hazard ratio [HR], 0.37; 0.23-0.60; P < .001). Nonrelapse mortality estimated 16% (± 4) at 5 years after allo-SCT. As a result, disease-free survival (DFS) at 5 years was significantly better in the donor group: 60 versus 42% in the no-donor group (HR: 0.60; 0.41-0.89; P = .01). After risk-group analysis, improved outcome was more pronounced in standard-risk patients with a donor, who experienced an overall survival of 69% at 5 years (P = .05). In conclusion, standard-risk ALL patients with a sibling donor may show favorable survival following SCT, due to both a strong reduction of relapse and a modest nonrelapse mortality. This trial is registered with http://www.trialregister.nl under trial ID NTR228. |
| doi_str_mv | 10.1182/blood-2008-07-168625 |
| format | Article |
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We evaluated outcome of patients with ALL in first complete remission (CR1), according to a sibling donor versus no-donor comparison. Eligible patients (433) were entered in 2 consecutive, prospective studies, of whom 288 (67%) were younger than 55 years, in CR1, and eligible to receive consolidation by either an autologous SCT or an allo-SCT. Allo-SCT was performed in 91 of 96 patients with a compatible sibling donor. Cumulative incidences of relapse at 5 years were, respectively, 24 and 55% for patients with a donor versus those without a donor (hazard ratio [HR], 0.37; 0.23-0.60; P < .001). Nonrelapse mortality estimated 16% (± 4) at 5 years after allo-SCT. As a result, disease-free survival (DFS) at 5 years was significantly better in the donor group: 60 versus 42% in the no-donor group (HR: 0.60; 0.41-0.89; P = .01). After risk-group analysis, improved outcome was more pronounced in standard-risk patients with a donor, who experienced an overall survival of 69% at 5 years (P = .05). In conclusion, standard-risk ALL patients with a sibling donor may show favorable survival following SCT, due to both a strong reduction of relapse and a modest nonrelapse mortality. This trial is registered with http://www.trialregister.nl under trial ID NTR228.</description><identifier>ISSN: 0006-4971</identifier><identifier>EISSN: 1528-0020</identifier><identifier>DOI: 10.1182/blood-2008-07-168625</identifier><identifier>PMID: 18988865</identifier><language>eng</language><publisher>Washington, DC: Elsevier Inc</publisher><subject>Adolescent ; Adult ; Antineoplastic Agents - therapeutic use ; Biological and medical sciences ; Disease-Free Survival ; Female ; Hematologic and hematopoietic diseases ; Hematopoietic Stem Cell Transplantation ; Humans ; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis ; Living Donors ; Male ; Medical sciences ; Middle Aged ; Neoplasm Recurrence, Local - diagnosis ; Neoplasm Recurrence, Local - therapy ; Precursor Cell Lymphoblastic Leukemia-Lymphoma - epidemiology ; Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy ; Prospective Studies ; Remission Induction ; Risk Factors ; Siblings ; Transplantation Conditioning ; Transplantation, Autologous - methods ; Transplantation, Homologous - methods ; Treatment Outcome ; Young Adult</subject><ispartof>Blood, 2009-02, Vol.113 (6), p.1375-1382</ispartof><rights>2009 © 2009 by The American Society of Hematology</rights><rights>2009 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c436t-56e1f8bd8911ebf78753d3d44d67719c98d73c33f7158d7d96458f54fbdcafca3</citedby><cites>FETCH-LOGICAL-c436t-56e1f8bd8911ebf78753d3d44d67719c98d73c33f7158d7d96458f54fbdcafca3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21100268$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18988865$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cornelissen, Jan J.</creatorcontrib><creatorcontrib>van der Holt, Bronno</creatorcontrib><creatorcontrib>Verhoef, Gregor E.G.</creatorcontrib><creatorcontrib>van 't Veer, Mars B.</creatorcontrib><creatorcontrib>van Oers, Marinus H.J.</creatorcontrib><creatorcontrib>Schouten, Harry C.</creatorcontrib><creatorcontrib>Ossenkoppele, Gert</creatorcontrib><creatorcontrib>Sonneveld, Pieter</creatorcontrib><creatorcontrib>Maertens, Johan</creatorcontrib><creatorcontrib>van Marwijk Kooy, Marinus</creatorcontrib><creatorcontrib>Schaafsma, Martijn R.</creatorcontrib><creatorcontrib>Wijermans, Pierre W.</creatorcontrib><creatorcontrib>Biesma, Douwe H.</creatorcontrib><creatorcontrib>Wittebol, Shulamit</creatorcontrib><creatorcontrib>Voogt, Paul J.</creatorcontrib><creatorcontrib>Baars, Joke W.</creatorcontrib><creatorcontrib>Zachée, Pierre</creatorcontrib><creatorcontrib>Verdonck, Leo F.</creatorcontrib><creatorcontrib>Löwenberg, Bob</creatorcontrib><creatorcontrib>Dekker, Adriaan W.</creatorcontrib><creatorcontrib>Dutch-Belgian HOVON Cooperative Group</creatorcontrib><title>Myeloablative allogeneic versus autologous stem cell transplantation in adult patients with acute lymphoblastic leukemia in first remission: a prospective sibling donor versus no-donor comparison</title><title>Blood</title><addtitle>Blood</addtitle><description>While commonly accepted in poor-risk acute lymphoblastic leukemia (ALL), the role of allogeneic hematopoietic stem cell transplantation (allo-SCT) is still disputed in adult patients with standard-risk ALL. We evaluated outcome of patients with ALL in first complete remission (CR1), according to a sibling donor versus no-donor comparison. Eligible patients (433) were entered in 2 consecutive, prospective studies, of whom 288 (67%) were younger than 55 years, in CR1, and eligible to receive consolidation by either an autologous SCT or an allo-SCT. Allo-SCT was performed in 91 of 96 patients with a compatible sibling donor. Cumulative incidences of relapse at 5 years were, respectively, 24 and 55% for patients with a donor versus those without a donor (hazard ratio [HR], 0.37; 0.23-0.60; P < .001). Nonrelapse mortality estimated 16% (± 4) at 5 years after allo-SCT. As a result, disease-free survival (DFS) at 5 years was significantly better in the donor group: 60 versus 42% in the no-donor group (HR: 0.60; 0.41-0.89; P = .01). After risk-group analysis, improved outcome was more pronounced in standard-risk patients with a donor, who experienced an overall survival of 69% at 5 years (P = .05). In conclusion, standard-risk ALL patients with a sibling donor may show favorable survival following SCT, due to both a strong reduction of relapse and a modest nonrelapse mortality. This trial is registered with http://www.trialregister.nl under trial ID NTR228.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Antineoplastic Agents - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>Hematologic and hematopoietic diseases</subject><subject>Hematopoietic Stem Cell Transplantation</subject><subject>Humans</subject><subject>Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis</subject><subject>Living Donors</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neoplasm Recurrence, Local - diagnosis</subject><subject>Neoplasm Recurrence, Local - therapy</subject><subject>Precursor Cell Lymphoblastic Leukemia-Lymphoma - epidemiology</subject><subject>Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy</subject><subject>Prospective Studies</subject><subject>Remission Induction</subject><subject>Risk Factors</subject><subject>Siblings</subject><subject>Transplantation Conditioning</subject><subject>Transplantation, Autologous - methods</subject><subject>Transplantation, Homologous - methods</subject><subject>Treatment Outcome</subject><subject>Young Adult</subject><issn>0006-4971</issn><issn>1528-0020</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9UcFu1DAUjBCIbgt_gJAvcAvYSew4HJCqigJSERc4W4790hocO9jOov0-foy3zQI3TvZ7mhmPZ6rqGaOvGJPN69HHaOuGUlnTvmZCioY_qHaMN7igDX1Y7Silou6Gnp1V5zl_o5R1bcMfV2dMDlJKwXfVr08H8FGPXhe3B6K9j7cQwBmyh5TXTPRaIu4iXnOBmRjwnpSkQ168DgVpMRAXiLarL2TBGULJ5Kcrd0SbtQDxh3m5i_hCLijrYf0Os9NHzuRSLiThmDPKvCGaLCnmBcy9mexG78ItsTHE9MdPiPU2mzgvOrkcw5Pq0aR9hqen86L6ev3uy9WH-ubz-49Xlze16VpRai6ATXK0cmAMxqmXPW9ta7vOir5ngxmk7VvTtlPPOF7tIDouJ95NozV6Mrq9qF5uumjyxwq5KDR-zEMHwHyUEFIOnDMEdhvQ4G9ygkktyc06HRSj6lieui9PHctTtFdbeUh7ftJfxxnsP9KpLQS8OAF0NtpP2IJx-S-uYQyLFxJxbzccYBp7B0llg7UYsC5htspG938nvwEkycAf</recordid><startdate>20090205</startdate><enddate>20090205</enddate><creator>Cornelissen, Jan J.</creator><creator>van der Holt, Bronno</creator><creator>Verhoef, Gregor E.G.</creator><creator>van 't Veer, Mars B.</creator><creator>van Oers, Marinus H.J.</creator><creator>Schouten, Harry C.</creator><creator>Ossenkoppele, Gert</creator><creator>Sonneveld, Pieter</creator><creator>Maertens, Johan</creator><creator>van Marwijk Kooy, Marinus</creator><creator>Schaafsma, Martijn R.</creator><creator>Wijermans, Pierre W.</creator><creator>Biesma, Douwe H.</creator><creator>Wittebol, Shulamit</creator><creator>Voogt, Paul J.</creator><creator>Baars, Joke W.</creator><creator>Zachée, Pierre</creator><creator>Verdonck, Leo F.</creator><creator>Löwenberg, Bob</creator><creator>Dekker, Adriaan W.</creator><general>Elsevier Inc</general><general>Americain Society of Hematology</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20090205</creationdate><title>Myeloablative allogeneic versus autologous stem cell transplantation in adult patients with acute lymphoblastic leukemia in first remission: a prospective sibling donor versus no-donor comparison</title><author>Cornelissen, Jan J. ; van der Holt, Bronno ; Verhoef, Gregor E.G. ; van 't Veer, Mars B. ; van Oers, Marinus H.J. ; Schouten, Harry C. ; Ossenkoppele, Gert ; Sonneveld, Pieter ; Maertens, Johan ; van Marwijk Kooy, Marinus ; Schaafsma, Martijn R. ; Wijermans, Pierre W. ; Biesma, Douwe H. ; Wittebol, Shulamit ; Voogt, Paul J. ; Baars, Joke W. ; Zachée, Pierre ; Verdonck, Leo F. ; Löwenberg, Bob ; Dekker, Adriaan W.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c436t-56e1f8bd8911ebf78753d3d44d67719c98d73c33f7158d7d96458f54fbdcafca3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Antineoplastic Agents - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Disease-Free Survival</topic><topic>Female</topic><topic>Hematologic and hematopoietic diseases</topic><topic>Hematopoietic Stem Cell Transplantation</topic><topic>Humans</topic><topic>Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis</topic><topic>Living Donors</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neoplasm Recurrence, Local - diagnosis</topic><topic>Neoplasm Recurrence, Local - therapy</topic><topic>Precursor Cell Lymphoblastic Leukemia-Lymphoma - epidemiology</topic><topic>Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy</topic><topic>Prospective Studies</topic><topic>Remission Induction</topic><topic>Risk Factors</topic><topic>Siblings</topic><topic>Transplantation Conditioning</topic><topic>Transplantation, Autologous - methods</topic><topic>Transplantation, Homologous - methods</topic><topic>Treatment Outcome</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cornelissen, Jan J.</creatorcontrib><creatorcontrib>van der Holt, Bronno</creatorcontrib><creatorcontrib>Verhoef, Gregor E.G.</creatorcontrib><creatorcontrib>van 't Veer, Mars B.</creatorcontrib><creatorcontrib>van Oers, Marinus H.J.</creatorcontrib><creatorcontrib>Schouten, Harry C.</creatorcontrib><creatorcontrib>Ossenkoppele, Gert</creatorcontrib><creatorcontrib>Sonneveld, Pieter</creatorcontrib><creatorcontrib>Maertens, Johan</creatorcontrib><creatorcontrib>van Marwijk Kooy, Marinus</creatorcontrib><creatorcontrib>Schaafsma, Martijn R.</creatorcontrib><creatorcontrib>Wijermans, Pierre W.</creatorcontrib><creatorcontrib>Biesma, Douwe H.</creatorcontrib><creatorcontrib>Wittebol, Shulamit</creatorcontrib><creatorcontrib>Voogt, Paul J.</creatorcontrib><creatorcontrib>Baars, Joke W.</creatorcontrib><creatorcontrib>Zachée, Pierre</creatorcontrib><creatorcontrib>Verdonck, Leo F.</creatorcontrib><creatorcontrib>Löwenberg, Bob</creatorcontrib><creatorcontrib>Dekker, Adriaan W.</creatorcontrib><creatorcontrib>Dutch-Belgian HOVON Cooperative Group</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Blood</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cornelissen, Jan J.</au><au>van der Holt, Bronno</au><au>Verhoef, Gregor E.G.</au><au>van 't Veer, Mars B.</au><au>van Oers, Marinus H.J.</au><au>Schouten, Harry C.</au><au>Ossenkoppele, Gert</au><au>Sonneveld, Pieter</au><au>Maertens, Johan</au><au>van Marwijk Kooy, Marinus</au><au>Schaafsma, Martijn R.</au><au>Wijermans, Pierre W.</au><au>Biesma, Douwe H.</au><au>Wittebol, Shulamit</au><au>Voogt, Paul J.</au><au>Baars, Joke W.</au><au>Zachée, Pierre</au><au>Verdonck, Leo F.</au><au>Löwenberg, Bob</au><au>Dekker, Adriaan W.</au><aucorp>Dutch-Belgian HOVON Cooperative Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Myeloablative allogeneic versus autologous stem cell transplantation in adult patients with acute lymphoblastic leukemia in first remission: a prospective sibling donor versus no-donor comparison</atitle><jtitle>Blood</jtitle><addtitle>Blood</addtitle><date>2009-02-05</date><risdate>2009</risdate><volume>113</volume><issue>6</issue><spage>1375</spage><epage>1382</epage><pages>1375-1382</pages><issn>0006-4971</issn><eissn>1528-0020</eissn><abstract>While commonly accepted in poor-risk acute lymphoblastic leukemia (ALL), the role of allogeneic hematopoietic stem cell transplantation (allo-SCT) is still disputed in adult patients with standard-risk ALL. We evaluated outcome of patients with ALL in first complete remission (CR1), according to a sibling donor versus no-donor comparison. Eligible patients (433) were entered in 2 consecutive, prospective studies, of whom 288 (67%) were younger than 55 years, in CR1, and eligible to receive consolidation by either an autologous SCT or an allo-SCT. Allo-SCT was performed in 91 of 96 patients with a compatible sibling donor. Cumulative incidences of relapse at 5 years were, respectively, 24 and 55% for patients with a donor versus those without a donor (hazard ratio [HR], 0.37; 0.23-0.60; P < .001). Nonrelapse mortality estimated 16% (± 4) at 5 years after allo-SCT. As a result, disease-free survival (DFS) at 5 years was significantly better in the donor group: 60 versus 42% in the no-donor group (HR: 0.60; 0.41-0.89; P = .01). After risk-group analysis, improved outcome was more pronounced in standard-risk patients with a donor, who experienced an overall survival of 69% at 5 years (P = .05). In conclusion, standard-risk ALL patients with a sibling donor may show favorable survival following SCT, due to both a strong reduction of relapse and a modest nonrelapse mortality. This trial is registered with http://www.trialregister.nl under trial ID NTR228.</abstract><cop>Washington, DC</cop><pub>Elsevier Inc</pub><pmid>18988865</pmid><doi>10.1182/blood-2008-07-168625</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Blood, 2009-02, Vol.113 (6), p.1375-1382 |
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| language | eng |
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| source | MEDLINE; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Adolescent Adult Antineoplastic Agents - therapeutic use Biological and medical sciences Disease-Free Survival Female Hematologic and hematopoietic diseases Hematopoietic Stem Cell Transplantation Humans Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis Living Donors Male Medical sciences Middle Aged Neoplasm Recurrence, Local - diagnosis Neoplasm Recurrence, Local - therapy Precursor Cell Lymphoblastic Leukemia-Lymphoma - epidemiology Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy Prospective Studies Remission Induction Risk Factors Siblings Transplantation Conditioning Transplantation, Autologous - methods Transplantation, Homologous - methods Treatment Outcome Young Adult |
| title | Myeloablative allogeneic versus autologous stem cell transplantation in adult patients with acute lymphoblastic leukemia in first remission: a prospective sibling donor versus no-donor comparison |
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