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Pediatric-inspired therapy compared to allografting for Philadelphia chromosome-negative adult ALL in first complete remission.
Seftel, Matthew D; Neuberg, Donna; Zhang, Mei-Jie; Wang, Hai-Lin; Ballen, Karen Kuhn; Bergeron, Julie; Couban, Stephen; Freytes, César O; Hamadani, Mehdi; Kharfan-Dabaja, Mohamed A; Lazarus, Hillard M; Nishihori, Taiga; Paulson, Kristjan; Saber, Wael; Sallan, Stephen E; Soiffer, Robert; Tallman, Martin S; Woolfrey, Ann E; DeAngelo, Daniel J; Weisdorf, Daniel J.
Afiliação
  • Seftel MD; Department of Medical Oncology and Haematology, CancerCare Manitoba, Winnipeg, Manitoba, Canada.
  • Neuberg D; Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, Massachutsetts.
  • Zhang MJ; Center for International Blood and Marrow Transplant Research (CIBMTR®), Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.
  • Wang HL; Medical College of Wisconsin, Division of Biostatistics, Institute for Health and Society, Milwaukee, Wisconsin.
  • Ballen KK; Center for International Blood and Marrow Transplant Research (CIBMTR®), Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.
  • Bergeron J; Department of Hematology/Oncology, Massachusetts General Hospital, Boston, Massachusetts.
  • Couban S; Department of Hematology, Hôpital Maisonneuve-Rosemont, Montréal, Quebec, Canada.
  • Freytes CO; Division of Haematology, Queen Elizabeth II Health Sciences Centre, Dalhousie University, Halifax, Nova Scotia, Canada.
  • Hamadani M; South Texas Veterans Health Care System and University of Texas Health Science Center San Antonio, San Antonio, Texas.
  • Kharfan-Dabaja MA; Center for International Blood and Marrow Transplant Research (CIBMTR®), Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.
  • Lazarus HM; Department of Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.
  • Nishihori T; Department of Medicine, Seidman Cancer Center, University Hospitals Case Medical Center, Cleveland, Ohio.
  • Paulson K; Department of Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.
  • Saber W; Department of Medical Oncology and Haematology, CancerCare Manitoba, Winnipeg, Manitoba, Canada.
  • Sallan SE; Center for International Blood and Marrow Transplant Research (CIBMTR®), Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.
  • Soiffer R; Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.
  • Tallman MS; Department of Medical Oncology/Hematologic Malignancies, Dana-Farber Cancer Institute, Boston, Massachusetts.
  • Woolfrey AE; Department of Medicine, Leukemia Service, Memorial Sloan Kettering Cancer Center, New York, New York.
  • DeAngelo DJ; Department of Pediatric Hematopoietic Cell Transplant, Fred Hutchinson Cancer Research Center, Seattle, Washington.
  • Weisdorf DJ; Department of Medical Oncology/Hematologic Malignancies, Dana-Farber Cancer Institute, Boston, Massachusetts.
Am J Hematol ; 91(3): 322-9, 2016 Mar.
Article em En | MEDLINE | ID: mdl-26701142
For adults with Philadelphia chromosome-negative (Ph-) acute lymphoblastic leukemia (ALL) in first complete remission (CR1), allogeneic hematopoietic cell transplantation (HCT) is an established curative strategy. However, pediatric-inspired chemotherapy may also offer durable leukemia-free survival in the absence of HCT. We compared 422 HCT recipients aged 18-50 years with Ph-ALL in CR1 reported to the CIBMTR with an age-matched concurrent cohort of 108 Ph- ALL CR1 patients who received a Dana-Farber Consortium pediatric-inspired non-HCT regimen. At 4 years of follow-up, incidence of relapse after HCT was 24% (95% CI 19-28) versus 23% (95% CI 15-32) for the non-HCT (chemo) cohort (P=0.97). Treatment-related mortality (TRM) was higher in the HCT cohort [HCT 37% (95% CI 31-42) versus chemo 6% (95% CI 3-12), P<0.0001]. DFS in the HCT cohort was 40% (95% CI 35-45) versus 71% (95% CI 60-79) for chemo, P<0.0001. Similarly, OS favored chemo [HCT 45% (95% CI 40-50)] versus chemo 73% [(95% CI 63-81), P<0.0001]. In multivariable analysis, the sole factor predictive of shorter OS was the administration of HCT [hazard ratio 3.12 (1.99-4.90), P<0.0001]. For younger adults with Ph- ALL, pediatric-inspired chemotherapy had lower TRM, no increase in relapse, and superior overall survival compared to HCT. Am. J. Hematol. 91:322-329, 2016. © 2015 Wiley Periodicals, Inc.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Indução de Remissão / Protocolos de Quimioterapia Combinada Antineoplásica / Transplante de Medula Óssea / Transplante de Células-Tronco Hematopoéticas / Leucemia Mieloide Crônica Atípica BCR-ABL Negativa Tipo de estudo: Prognostic_studies Limite: Adolescent / Adult / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2016 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Indução de Remissão / Protocolos de Quimioterapia Combinada Antineoplásica / Transplante de Medula Óssea / Transplante de Células-Tronco Hematopoéticas / Leucemia Mieloide Crônica Atípica BCR-ABL Negativa Tipo de estudo: Prognostic_studies Limite: Adolescent / Adult / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2016 Tipo de documento: Article