PURPOSE: Few patients with Philadelphia-positive acute lymphoblastic leukemia (Ph-positive ALL) have been cured by chemotherapy alone. Registry figures show that 38% of patients who have a matched-sibling bone marrow transplant (BMT) are disease-free 2 years after transplant, but the majority of patients lack a sibling donor. Most modern ALL protocols recommend unrelated donor (UD) BMT for patients with Ph-positive ALL in first complete remission (CR1), but the outcome of this is unknown. PATIENTS AND METHODS: We report the results of 15 children and adolescents who had a T-cell depleted UD-BMT for Ph-positive ALL. Thirteen of 15 had been previously treated on United Kingdom ALL protocols. Nine were in CR1 and six had more advanced disease. Eleven donor recipient pairs were matched at HLA-A, HLA-B, HLA-DR, and HLA-DQ, and four were mismatched at one or two HLA loci. RESULTS: The incidence of greater than grade I acute and chronic graft-versus-host disease (GVHD) was low (13% and 8%, respectively). Six patients have relapsed and seven patients survive at a median of 21 months post-BMT; six of seven are disease free. All seven survivors are in full-time education or work. The 2-year overall and disease-free survivals are 44% +/- 13% and 37% +/- 13% (+/- SE). None of four patients who had mismatched donors survived, but seven of 11 matched recipients survive (P < .05). CONCLUSION: UD-BMT can produce prolonged disease-free survival in young patients with Ph-positive ALL who otherwise would have an extremely poor outlook.
PURPOSE: Few patients with Philadelphia-positive acute lymphoblastic leukemia (Ph-positive ALL) have been cured by chemotherapy alone. Registry figures show that 38% of patients who have a matched-sibling bone marrow transplant (BMT) are disease-free 2 years after transplant, but the majority of patients lack a sibling donor. Most modern ALL protocols recommend unrelated donor (UD) BMT for patients with Ph-positive ALL in first complete remission (CR1), but the outcome of this is unknown. PATIENTS AND METHODS: We report the results of 15 children and adolescents who had a T-cell depleted UD-BMT for Ph-positive ALL. Thirteen of 15 had been previously treated on United Kingdom ALL protocols. Nine were in CR1 and six had more advanced disease. Eleven donor recipient pairs were matched at HLA-A, HLA-B, HLA-DR, and HLA-DQ, and four were mismatched at one or two HLA loci. RESULTS: The incidence of greater than grade I acute and chronic graft-versus-host disease (GVHD) was low (13% and 8%, respectively). Six patients have relapsed and seven patients survive at a median of 21 months post-BMT; six of seven are disease free. All seven survivors are in full-time education or work. The 2-year overall and disease-free survivals are 44% +/- 13% and 37% +/- 13% (+/- SE). None of four patients who had mismatched donors survived, but seven of 11 matched recipients survive (P < .05). CONCLUSION: UD-BMT can produce prolonged disease-free survival in young patients with Ph-positive ALL who otherwise would have an extremely poor outlook.
Authors: Prakash Satwani; Harland Sather; Fevzi Ozkaynak; Nyla A Heerema; Kirk R Schultz; Jean Sanders; John Kersey; Virginia Davenport; Michael Trigg; Mitchell S Cairo Journal: Biol Blood Marrow Transplant Date: 2007-02 Impact factor: 5.742
Authors: Steven Z Pavletic; Shaji Kumar; Mohamad Mohty; Marcos de Lima; James M Foran; Marcelo Pasquini; Mei-Jie Zhang; Sergio Giralt; Michael R Bishop; Daniel Weisdorf Journal: Biol Blood Marrow Transplant Date: 2010-04-24 Impact factor: 5.742
Authors: Bella Patel; Keiren E Kirkland; Richard Szydlo; Rachel M Pearce; Richard E Clark; Charles Craddock; Effie Liakopoulou; Adele K Fielding; Stephen Mackinnon; Eduardo Olavarria; Mike N Potter; Nigel H Russell; Bronwen E Shaw; Gordon Cook; Anthony H Goldstone; David I Marks Journal: Haematologica Date: 2009-07-31 Impact factor: 9.941
Authors: M Eefting; C J M Halkes; L C de Wreede; C M van Pelt; S Kersting; E W A Marijt; P A von dem Borne; R Willemze; H Veelken; J H F Falkenburg Journal: Bone Marrow Transplant Date: 2013-08-12 Impact factor: 5.483
Authors: David I Marks; Waleska S Pérez; Wensheng He; Mei-Jie Zhang; Michael R Bishop; Brian J Bolwell; Christopher N Bredeson; Edward A Copelan; Robert Peter Gale; Vikas Gupta; Gregory A Hale; Luis M Isola; Ann A Jakubowski; Armand Keating; Thomas R Klumpp; Hillard M Lazarus; Jane L Liesveld; Richard T Maziarz; Philip L McCarthy; Mitchell Sabloff; Gary Schiller; Jorge Sierra; Martin S Tallman; Edmund K Waller; Peter H Wiernik; Daniel J Weisdorf Journal: Blood Date: 2008-04-08 Impact factor: 22.113