Comparative analysis between autologous and allogeneic hematopoietic stem cell transplantation in 114 adult patients with acute lymphoblastic leukemia in long-term follow-up.
- Author:
Yu-Shi BAO
1
;
Er-Lie JIANG
;
Mei WANG
;
Hua WANG
;
Yong HUANG
;
Jia-Lin WEI
;
Dong-Lin YANG
;
Si-Zhou FENG
;
Lu-Gui QIU
;
Ming-Zhe HAN
Author Information
1. Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300020, China.
- Publication Type:Journal Article
- MeSH:
Adolescent;
Adult;
Disease-Free Survival;
Female;
Follow-Up Studies;
Hematopoietic Stem Cell Transplantation;
methods;
Humans;
Male;
Middle Aged;
Precursor Cell Lymphoblastic Leukemia-Lymphoma;
surgery;
Prognosis;
Retrospective Studies;
Transplantation Conditioning;
Transplantation, Homologous;
Young Adult
- From:
Journal of Experimental Hematology
2008;16(6):1325-1329
- CountryChina
- Language:Chinese
-
Abstract:
This study was aimed to explore the effect of autologous hematopoietic stem cell transplantation (auto-HSCT) and allogeneic hematopoietic stem cell transplantation (allo-HSCT) in adult patients with acute lymphoblastic leukemia and to analyze the related prognostic factors. Clinical data of 114 ALL patients receiving HSCT, including 70 auto-HSCT and 44 allo-HSCT, were retrospectively analyzed. Disease-free-survival (DFS), relapse-rate (RR) and transplantation-related-mortality (TRM) of patients receiving different HSCT were compared. The results showed that the eight-year OS and DFS in a total of 114 adult ALL patients were (40.89+/-5.27)% and (39.50+/-5.22)% respectively. The three-year DFS of ALL patients who received HSCT in phase CR1 and no CR1 were (47.63+/-5.63)% and (17.65+/-9.25)% (p=0.0034). The two-year DFS of patients who received allo-HSCT and had I/II aGVHD was (62.75+/-12.30)%, and the six-month DFS of patients who had III/IV aGVHD was 0, and the two-year DFS of patients without aGVHD was (29.35+/-9.70)% (p=0.005). The three-year DFS of patients with and without maintenance chemotherapy after transplantation were (55.12+/-7.89)% and (33.33+/-11.11)% respectively, there was significant difference between them (p=0.0499). The five-year DFS between patients received auto-HSCT and allo-HSCT in phase CR1 was not significantly different. The RR of patients received allo-HSCT was lower than that of patients received auto-HSCT, but there was no significant difference between them. The TRM of patients received allo-HSCT was higher than of patients received auto-HSCT (p=0.0313). Expression of myeloid antigen and higher LDH level in diagnosis were poor- prognostic factors. It is concluded that auto-HSCT and allo-HSCT completed in phase CR1 may improve prognosis of the patient with ALL as a method for consolidation chemotherapy, but no significant difference exists between the two HSCTs. Patients receiving allo-HSCT and having I/II aGVHD may achieve higher DFS. The maintaining chemotherapy for patients after auto-HSCT may improve therapeutic effect.
