ABSTRACT
Cold-pressed Camelina oil is a traditional oil registered as a traditional food in Poland. Camelina oil has health-promoting properties and high oxidative stability. This may be due to the presence of various bioactive antioxidant compounds such as carotenoids, sterols and polyphenols. Bioactive compounds content in Camelina oil depends mainly on the varieties and on the conditions under which the crop was grown therefore the aim of the research was to analyse antioxidant bioactive compounds in oil from different cultivars of Camelina sativa seeds and to determine their relationship with oil parameters.
Subject(s)
Antioxidants , Brassicaceae , Plant Oils , Poland , Antioxidants/chemistry , Antioxidants/pharmacology , Antioxidants/isolation & purification , Plant Oils/chemistry , Plant Oils/isolation & purification , Plant Oils/pharmacology , Brassicaceae/chemistry , Brassicaceae/metabolism , Seeds/chemistry , Polyphenols/chemistry , Polyphenols/isolation & purification , Polyphenols/pharmacology , Polyphenols/analysisABSTRACT
The symptoms of celery allergy are mainly presented as oral allergy symptom, but there are several case reports of patients who experienced anaphylaxis. Defensin (Api g 7), as a novel allergen in celery root, was described in 2022 r. The female patient had a history of several episodes of dyspnea and cough, associated with ingestion of spice mixes containing dried celery. Up to the point of hospitalization, there were no objective tests, either sIgE or skin prick tests, that would confirm celery sensitization. During hospitalization, patient had a positive double-blind placebo-controlled food challenge with cooked celery. The patient was sensitized to mugwort defensin Art v 1. An inhibition assay with celery allergen extract was performed to prove cross-sensitization between Art v 1 and celery allergen responsible for symptoms in the patient. In conclusion, Api g 7 is an important celery allergen that can be responsible for severe reactions. Its cross-reactivity with Art v 1 is characteristic. Negative diagnostic tests with celery do not exclude Api g 7 sensitization.
Subject(s)
Anaphylaxis , Food Hypersensitivity , Humans , Female , Anaphylaxis/diagnosis , Food Hypersensitivity/diagnosis , Pollen , Plant Proteins/adverse effects , Allergens , Defensins , Skin Tests/adverse effectsABSTRACT
The popularity of hemp cultivation for industrial purposes has been steadily growing for many years. With the addition of products derived from these plants to the Novel Food Catalogue, maintained by the European Commission, a significant increase in interest in hemp food is also expected. The aim of the study was to determine the characteristics of hempseed, oil, and oil cake samples produced from experimental plots grown in different conditions. The research was conducted on the Henola variety, one of the newest and most popular varieties of hemp, recently bred for grain and oil. The content of bioactive compounds in grain and oil has been subjected to detailed chemical analyses in order to determine the effect of fertilization, the method of plant cultivation, and processing conditions on their quantity. The test results and the statistical analysis carried out showed a significant impact of the tested factors on the content of some of the tested bioactive compounds. The obtained results will help in the development of an effective method of cultivation for this hemp variety in order to maximize the content of the desired bioactive compounds per unit of cultivation area.
Subject(s)
Cannabis , Cannabis/chemistry , Seeds/chemistry , Plant Breeding , Minerals/analysis , FertilizationABSTRACT
Despite the popularity of concentrated feed, fodder crops are still important, especially in organic livestock farming. However, this type of feed must meet certain criteria, which are often described using correct nutrient ratios. The research investigates the influence of compost and fly ash on quantitative changes in nutrient ratios determined for lupine and oat cultivated on soil slightly contaminated with Cu. A pot experiment was conducted on medium soil. Immobilizing agents (compost and fly ash) were applied at the dose of 40 t per ha. Plant materials were subjected to chemical analyses to assess their macronutrient content and, based on these data, mutual proportions of individual nutrients were calculated as mass ratios of K:Mg, K:Na, Ca:P, Ca:Mg, K:(Ca+Mg) and (K+Na):(Ca+Mg). Changes in ratio values were visualized using statistical tools, i.e., Anova, correlation coefficients and dendrograms. It was found that immobilizing agents constituted a source of the chosen nutrients because their amounts in plants grown on the soil fertilized with either compost or fly ash compost were significantly higher than in the control plants. This phenomenon was especially visible with regard to Ca and Mg for both lupine and oat. It should be emphasized here that the effect of compost or fly ash on the content of Ca and K in plants was comparable. In general, the application of compost contributed to higher values of the analyzed nutrients in both plants. The control and fertilized fly ash plants were characterized by lower values of nutrient ratios. The expected optimal value range of 2-3:1 was determined only for Ca:Mg, which was found in both lupine and oats. The proper values of K:Mg (2-6:1) were found only in the case of fodder plants cultivated on soil amended with compost.
Subject(s)
Composting , Soil Pollutants , Animal Feed/analysis , Coal Ash/analysis , Nutrients/analysis , Plants , Soil/chemistry , Soil Pollutants/analysisABSTRACT
Camelina oil obtained from the seeds of Camelina sativa exhibits strong antioxidative properties. This study was based on four years of field experiments conducted on 63 genotypes of spring and 11 genotypes of winter camelina. The aim of the study was to determine the variability in the content of the selected bioactive compounds, depending on the weather conditions during the cultivation, the functional form, and genotype. The cultivation form of the genotypes analysed in our study did not exhibit significant differences in the quantitative profiles of the tested phenolic acids and flavonoids. Sinapic acid was the most abundant of all phenolic acids under analysis (617-668 mg/kg), while quercetin was the main flavonoid (91-161 mg/kg). Camelina has great potential not only for the food industry but also for researchers attempting to breed an oil plant with the stable biosynthesis of bioactive compounds to ensure oxidative protection of obtained fat.
Subject(s)
Brassicaceae , Flavonoids , Brassicaceae/genetics , Genotype , Plant Breeding , Seeds/genetics , WeatherABSTRACT
Trials assessing first-line, fixed-duration approaches in chronic lymphocytic leukemia (CLL) are yielding promising activity, but few long-term data are available. We report follow-up data from a phase 2 trial (ICLL07 FILO) in previously untreated, medically fit patients (N = 135). Patients underwent obinutuzumab-ibrutinib induction for 9 months; then, following evaluation (N = 130 evaluable), those in complete remission and with bone marrow measurable residual disease (BM MRD) <0.01% (n = 10) received ibrutinib for 6 additional months; those in partial remission and/or with BM MRD ≥0.01%, the majority (n = 120), also received 4 cycles of immunochemotherapy (fludarabine/cyclophosphamide-obinutuzumab). Beyond end of treatment, responses were assessed every 3 month and peripheral blood MRD every 6 months. At median follow-up 36.7 months from treatment start, progression-free and overall survival rates (95% confidence interval) at 3 years were 95.7% (92.0% to 99.5%) and 98% (95.1% to 100%), respectively. Peripheral blood MRD <0.01% rates were 97%, 96%, 90%, 84%, and 89% at months 16, 22, 28, 34, and 40, respectively. No new treatment-related or serious adverse event occurred beyond end of treatment. Thus, in previously untreated, medically fit patients with CLL, a fixed-duration (15 months), MRD-guided approach achieved high survival rates, a persistent MRD benefit beyond the end of treatment, and low long-term toxicity. This trial was registered at www.clinicaltrials.gov as #NCT02666898.
Subject(s)
Adenine/analogs & derivatives , Antibodies, Monoclonal, Humanized/therapeutic use , Antineoplastic Agents, Immunological/therapeutic use , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy , Piperidines/therapeutic use , Adenine/administration & dosage , Adenine/adverse effects , Adenine/therapeutic use , Antibodies, Monoclonal, Humanized/administration & dosage , Antibodies, Monoclonal, Humanized/adverse effects , Antineoplastic Agents, Immunological/administration & dosage , Antineoplastic Agents, Immunological/adverse effects , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Cyclophosphamide/administration & dosage , Cyclophosphamide/adverse effects , Cyclophosphamide/therapeutic use , Follow-Up Studies , Humans , Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis , Neoplasm, Residual/diagnosis , Neoplasm, Residual/drug therapy , Piperidines/administration & dosage , Piperidines/adverse effects , Remission Induction , Treatment Outcome , Vidarabine/administration & dosage , Vidarabine/adverse effects , Vidarabine/therapeutic useABSTRACT
Clinical symptoms of food allergy may affect not only the digestive tract, but also the respiratory system, skin, or cardiovascular system. They may manifest themselves as gastrointestinal problems, asthma attacks, hives, or anaphylactic shock. Allergic reactions of the gastrointestinal tract may be IgE-independent (oral anaphylaxis syndrome, acute gastrointestinal reactions), mixed (eosinophilic gastrointestinal disorders), or IgE-independent (food-induced enterocolitis, proctitis, or enteropathy). The most serious conditions in which allergic background plays or can play an important role are: oral anaphylaxis syndrome, aphthous stomatitis, reflux disease, acute and chronic allergic reactions of gastric mucosa, irritable bowel syndrome, and eosinophilic gastrointestinal disorders.
ABSTRACT
Camelina oil is increasingly popular as consumption as oil. Erucic acid is an unwanted fatty acid in oil. First studies on several genotypes have shown that this oil contains varying amounts of eriuc acid. The aim of the study was to analyses content of eriuc acid in all genotypes camelina. Hypothesis was that the content of erucic acid in winter forms is lower than in spring ones. A field experiment with 65 spring genotypes and 9 winter genotypes of camelina was conducted in Poland from 2016 to 2018. The analyses based on two chromatographic methods, i.e. UPLC-DAD and GC-MS, showed no differences in the results for the camelina samples. The average percentage content of the erucic acid in the spring genotypes was 3.432%, and in the winter genotypes was 0.1%. Our three-year research shows that some winter varieties can be used as low erucic acid forms.
Subject(s)
Brassicaceae/chemistry , Plant Oils/chemistry , Brassicaceae/genetics , Erucic Acids/chemistry , Genotype , Poland , Seasons , Seeds/chemistry , Seeds/geneticsABSTRACT
INTRODUCTION: The level of fear of hymenoptera associated with stinging or envenomation may depend on situational factors and on trait anxiety characteristic of each patient. AIM: To assess the relationship between fear of stinging insects on the one hand and state anxiety and trait anxiety on the other in a group of patients with hymenoptera venom allergy. MATERIAL AND METHODS: The study was conducted by the Department of Allergy, Clinical Immunology and Internal Diseases, Dr J. Biziel University Hospital No. 2 in Bydgoszcz, Poland. A total of 114 patients (71 women (63%) and 43 men (37%)) with hymenoptera venom allergy undergoing immunotherapy participated in the study. The State-Trait Anxiety Inventory (STAI) and a dedicated scale developed by the authors for this study were used. RESULTS: State anxiety was found to significantly (p < 0.05) correlate with anxiety in the present moment (R = 0.247), in a situation of real danger (appearance of an insect) (R = 0.223) and during the spring and summer seasons (R = 0.278). Trait anxiety was found to significantly (p < 0.05) correlate with anxiety before immunotherapy (R = 0.261), in the present moment (R = 0.257), in a situation of real danger (appearance of an insect) (R = 0.254), and after an insect sting (R = 0.236). These were also weak correlations. The correlation between trait anxiety and anxiety during the spring and summer seasons was moderate (R = 0.331). CONCLUSIONS: The levels of trait and state anxiety are associated with the magnitude of the fear of the danger. Respondents showed a higher level of anxiety in a situation of danger and after an insect sting.
ABSTRACT
BACKGROUND: In patients with chronic lymphocytic leukaemia, achievement of a complete response with minimal residual disease of less than 0·01% (ie, <1 chronic lymphocytic leukaemia cell per 10â000 leukocytes) in bone marrow has been associated with improved progression-free survival. We aimed to explore the activity of induction therapy for 9 months with obinutuzumab and ibrutinib, followed up with a minimal residual disease-driven therapeutic strategy for 6 additional months, in previously untreated patients. METHODS: We did a single-arm, phase 2 trial in 27 university hospitals, general hospitals, and specialist cancer centres in France. Eligible patients were at least 18 years old and previously untreated, and had immunophenotypically confirmed B-cell chronic lymphocytic leukaemia; an Eastern Cooperative Oncology Group (ECOG) performance status score of less than 2; a Binet stage C according to IWCLL 2008 criteria or Binet stage A and B with active disease; no 17p deletion or absence of p53 mutation; and were considered medically fit. In the first part of the study (induction phase), all participants received eight intravenous infusions of obinutuzumab 1000 mg over six 4-weekly cycles and oral ibrutinib 420 mg once per day for 9 months. In part 2, after assessment on day 1 of month 9, patients with a complete response and bone marrow minimal residual disease of less than 0·01% received only oral ibrutinib 420 mg once per day for 6 additional months. Patients with a partial response, or with a complete response and bone marrow minimal residual disease of 0·01% or more, received 6 months of four 4-weekly cycles of intravenous fludarabine, cyclophosphamide, and obinutuzumab 1000 mg, alongside continuing ibrutinib 420 mg once per day. The primary endpoint was the proportion of patients achieving a complete response with bone marrow minimal residual disease less than 0·01% on day 1 of month 16 assessed by intention to treat (ITT). This trial is registered with ClinicalTrials.gov (number NCT02666898) and is still open for follow-up. FINDINGS: Between Oct 27, 2015, and May 16, 2017, 135 patients were enrolled. After induction treatment (day 1 of month 9), 130 patients were evaluable, of which ten (8%) achieved a complete response with bone marrow minimal residual disease of less than 0·01% and were assigned to ibrutinib, and 120 (92%) were assigned to ibrutinib plus fludarabine, cyclophosphamide, and obinutuzumab. After minimal residual disease-guided treatment (day 1 of month 16), 84 (62%, 90% CI 55-69) of 135 patients (ITT population) achieved a complete response with bone marrow minimal residual disease of less than 0·01%. The most common haematological adverse event was thrombocytopenia (in 45 [34%] of 133 patients at grade 1-2 in months 1-9 and in 43 [33%] of 130 patients at grade 1-2 in months 9-15). The most common non-haematological adverse events were infusion-related reactions (in 83 [62%] patients at grade 1-2 in months 1-9) and gastrointestinal disorders (in 62 [48%] patients at grades 1 and 2 in months 9-15). 49 serious adverse events occurred, most frequently infections (ten), cardiac events (eight), and haematological events (eight). No treatment-related deaths occurred. INTERPRETATION: Obinutuzumab and ibrutinib induction therapy followed by a minimal residual disease driven strategy is safe and active in patients with previously untreated chronic lymphocytic leukaemia. With longer follow-up, including assessing the evolution of minimal residual disease, if response is maintained, this strategy could be an option in the first-line setting in patients with chronic lymphocytic leukaemia, although randomised evidence is needed. FUNDING: Roche, Janssen.
Subject(s)
Antibodies, Monoclonal, Humanized/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy , Pyrazoles/administration & dosage , Pyrimidines/administration & dosage , Adenine/analogs & derivatives , Aged , Antibodies, Monoclonal, Humanized/adverse effects , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Drug Administration Schedule , Female , Gastrointestinal Diseases/etiology , Humans , Immunoglobulin Heavy Chains/genetics , Leukemia, Lymphocytic, Chronic, B-Cell/mortality , Leukemia, Lymphocytic, Chronic, B-Cell/pathology , Male , Middle Aged , Mutation , Neoplasm, Residual , Piperidines , Pyrazoles/adverse effects , Pyrimidines/adverse effects , Survival Rate , Thrombocytopenia/etiology , Treatment Outcome , Tumor Suppressor Protein p53/geneticsABSTRACT
Indoor swimming pools can be used all year round and serve for one of the most popular sport pursued for recreation. The positive effect of swimming arises in particular from the involvement of all the muscles of the body, decreasing the burden on the joints, as well as functional improvement of both the lungs and heart. Chlorine is typically used to disinfect swimming pool water and as a result the changes that take place lead to the formation of by-products, such as monochloramines (NH2Cl), dichloramines (NH2Cl2) i trichloramines (NH2Cl3), trihalogenometans (THM) or haloacetic acid (HAA). The highest concentration of these substances is just above the water surface and they may cause irritation of skin, eyes and mucosa of the respiratory tract. The toxic effect of high chlorine concentration and its side-products on the respiratory system is known, but the effect of low concentrations of these compounds is still not fully determined. Recent studies suggest that development of allergic diseases among swimmers may be increased by epithelial disorders driven by airway barrier dysfunction caused by chlorine irritation. Swimming in chlorinated water may be linked to symptoms of bronchial hyperreactivity, asthma and rhinitis especially in children, elite swimmers and employees of indoor swimming pools. Hypersensivity pneumonitis related to the use of swimming pools may manifest as a swimming pool or sauna user lung, most commonly caused by water polluting pathogens. The article summarizes recent data concerning the influence of chlorinated water on the development of allergic diseases.
Subject(s)
Chlorine/adverse effects , Disinfectants/adverse effects , Hypersensitivity/etiology , Water/analysis , Halogenation , Humans , Hypersensitivity/immunology , Swimming , Water/adverse effectsABSTRACT
Ibrutinib has revolutionized the management of chronic lymphocytic leukemia and is now being increasingly used. Although considered to be less immunosuppressive than conventional immunochemotherapy, the observation of a few cases of invasive fungal infections in patients treated with ibrutinib prompted us to conduct a retrospective survey. We identified 33 cases of invasive fungal infections in patients receiving ibrutinib alone or in combination. Invasive aspergillosis (IA) was overrepresented (27/33) and was associated with cerebral localizations in 40% of the cases. Remarkably, most cases of invasive fungal infections occurred with a median of 3 months after starting ibrutinib. In 18/33 cases, other conditions that could have contributed to decreased antifungal responses, such as corticosteroids, neutropenia, or combined immunochemotherapy, were present. These observations indicate that ibrutinib may be associated with early-onset invasive fungal infections, in particular IA with frequent cerebral involvement, and that patients on ibrutinib should be closely monitored in particular when other risk factors of fungal infections are present.
Subject(s)
Aspergillosis/chemically induced , Aspergillosis/epidemiology , Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy , Leukemia, Lymphocytic, Chronic, B-Cell/epidemiology , Pyrazoles/administration & dosage , Pyrazoles/adverse effects , Pyrimidines/administration & dosage , Pyrimidines/adverse effects , Adenine/analogs & derivatives , Female , Humans , Leukemia, Lymphocytic, Chronic, B-Cell/microbiology , Male , Piperidines , Time FactorsABSTRACT
INTRODUCTION: The prevalence of food allergies and other allergic reactions is increasing worldwide, particularly in highly-urbanized populations. Cell adhesion molecules are expressed in response to various pro-inflammatory cytokines. The expression of intercellular adhesion molecule 1 - ICAM-1 (CD54), ICAM-1 (CD106), P-selectin (CD62P), and E-selectin (CD62E) on vascular endothelial cells is induced by such pro-inflammatory cytokines as tumor necrosis factor α (TNF-α) and interleukin-1 (IL-1). AIM: To analyze concentrations of E-selectin and platelet endothelial cell adhesion molecule-1 (PECAM-1) in patients with an allergic type of food sensitivity co-existing with gastritis and to compare them to the values determined in individuals with dyspeptic symptoms not associated with allergic disorders. MATERIAL AND METHODS: The study included 80 patients, among them 50 individuals with food sensitivity confirmed based on compulsory standards, and 30 subjects with dyspeptic symptoms not accompanied by allergic conditions. Venous blood samples were taken from each patient and concentrations of E-selectin and PECAM-1 were determined by means of ELISA. RESULTS: Mean concentrations of sE-selectin and sPECAM-1 in patients with food allergy amounted to 54.0 ±21.6 ng/ml and 132.8 ±31.4 ng/ml, respectively. In individuals without food allergy, mean concentrations of sE-selectin and sPECAM-1 were 57.7 ±17.9 ng/ml and 139.6 ±31.1 ng/ml, respectively. Patients with food allergy and individuals with dyspeptic symptoms not associated with food allergy did not differ significantly in terms of sE-selectin concentrations (Mann-Whitney U-test, p = 0.453028). Similarly, no significant intergroup differences were observed with regard to sPECAM-1 concentrations (Mann-Whitney U-test, p = 0.231054). CONCLUSIONS: Adhesion molecules play an important role in the development of inflammation. This study did not find significant differences in the concentrations of such molecules as sE-selectin and sPECAM-1 between patients with food allergy and gastritis, and subjects in whom gastritis was not accompanied by atopic disorders. A positive correlation between the concentrations of sPECAM-1 and E-selectin was observed in food allergy patients. Consequently, it can be concluded that these molecules participate in the pathogenesis of the inflammatory process independently of the etiopathogenesis of gastritis.
ABSTRACT
AIM: To evaluate the influence of selected socio-demographic factors on quality of life of patients with different degrees of asthma severity. MATERIAL AND METHODS: The study was conducted in 2009-2010 in the Clinic of Allergology, Clinical Immunology and Internal Diseases in Dr J. Biziel University Hospital No. 2 in Bydgoszcz. Patients were divided into a tested group (126) and a control group (86). The criterion for the division was the degree of asthma control according to GINA 2006. The following tools were used: the author's questionnaire containing questions about socio-demographic and clinical data, and the WHOQOL-100. RESULTS: In the tested group, a statistically significant correlation was observed between quality of life and age (p < 0.002 for the entire population), education (p < 0.05 in the group with controlled asthma, p = 0.0005 for the entire population), professional activity (p < 0.003 in the group with partially controlled asthma, p < 0.05 with uncontrolled asthma and p < 0.0001 in the entire population), marital status (p = 0.025 for the entire population) and financial situation (p < 0.0001; p < 0.0002; p < 0.009 in all groups; p < 0.0001 in the entire population). There was no significant difference between quality of life, and sex and the place of residence of the respondents. CONCLUSIONS: Age, education, professional activity, marital status and financial situation affect the assessment of quality of life in patients with asthma. Socio-demographic factors such as sex and the place of residence do not influence the assessment of quality of life in patients with asthma.
ABSTRACT
BACKGROUND AND OBJECTIVES: T-lymphoblastic lymphoma is an infrequent disease usually treated as T-acute lymphoblastic leukemia with an induction chemotherapy course and sequential reinduction and maintenance chemotherapy. The T-LBL/ALL-GOELAL02 study evaluated the impact of randomized reinduction chemotherapy against intensified conditioning followed by autologous stem cell transplantation (ASCT), after an induction regimen of the type used for acute lymphoblastic leukemia (ALL). DESIGN AND METHODS: Patients with favorable characteristics were randomized to receive chemotherapy or ASCT. Patients with unfavorable characteristics (bone marrow involvement and age over 35 years old or leukocytosis >30 x 10(9)/L or failure to achieve medullar complete remission [CR] after one induction course) received a second induction course and ASCT. RESULTS: Among 45 patients, the CR rate was 71% after induction and 87% after a second induction course. Within the group of 27 patients with favorable characteristics, ten received ASCT and 17 chemotherapy. Ten patients in the group with unfavorable characteristics received ASCT. The 7-year overall survival and progression-free survival rates were 64 and 65%, respectively. Surprisingly, CR obtained after only two induction courses was associated with improved overall survival (p=0.04). None of the known prognostic factors significantly affected survival. INTERPRETATION AND CONCLUSIONS: Randomized maintenance or high-dose therapy (HDT) and ASCT or intensified HDT according to initial presentation gave similar overall and relapse-free survival rates. However, HDT allowed sparing of mediastinal irradiation and shortened treatment duration.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy , Stem Cell Transplantation , Adolescent , Adult , Disease-Free Survival , Female , Humans , Leukocyte Count , Male , Middle Aged , Precursor Cell Lymphoblastic Leukemia-Lymphoma/blood , Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Precursor Cell Lymphoblastic Leukemia-Lymphoma/mortality , Remission Induction , Survival Rate , Transplantation, AutologousABSTRACT
Various transplantation strategies have been designed to improve the poor prognosis of adult (ages 15 to 60 years) acute lymphoblastic leukemia (ALL). The GOELAL02 trial evaluated the impact of early allogeneic bone marrow transplantation (alloBMT) or delayed unpurged autologous stem cell transplantation (ASCT) for patients who had no human leukocyte antigen (HLA)-matched sibling donor or who were older than 50 years. Inclusion criteria included at least one of the following: age older than 35 years; non-T-ALL; leukocytosis greater than 30 x 10(9)/L; t(9;22), t(4;11), or t(1; 19); or failure to achieve complete remission (CR) after one induction course. Among 198 patients, the median age was 33 years. The CR rate was 80% with vincristine, idarubicine, L-asparaginase, and randomized intravenous injection or oral steroids (P = nonsignificant [ns]). AlloBMT was performed after 2 consolidation courses while ASCT was delayed after 1 additional reinduction. Intensified conditioning regimen before transplantation included etoposide, cyclophosphamide, and total body irradiation (TBI). Median follow-up was 5.1 years. The median overall survival (OS) was 29 months, with a 6-year OS of 41%. On an intent-to-treat analysis for patients younger than 50 years, alloBMT significantly improved the 6-year OS (75% versus 40% after ASCT; P = .0027). Randomized interferon-alpha maintenance had no effect on relapse or survival after ASCT. In conclusion, the outcome of adult ALL is better after early alloBMT than after delayed ASCT.