1.Outcomes of adults with Ph-negative B-cell acute lymphoblastic leukemia after autologous hematopoietic stem cell transplantation and the significance of minimal residual disease.
Zhe DING ; Mingzhe HAN ; Shulian CHEN ; Qiaoling MA ; Jialin WEI ; Aiming PANG ; Yong HUANG ; Xiaoyu ZHANG ; Chen LIANG ; Xin LIU ; Jianfeng YAO ; Gang LI ; Yigeng CAO ; Sizhou FENG ; Erlie JIANG
Chinese Journal of Hematology 2015;36(7):587-592
OBJECTIVETo better understand predictive factors and role of autologous hematopoietic stem cell transplantation (auto-HSCT)in the post-remission therapy for adult Ph-negative B-cell acute lymphoblastic leukemia (B-ALL)patients.
METHODSOutcomes of 86 adult patients with B-ALL who received auto-HSCT in our center from January 1996 to February 2014 were retrospectively analyzed.
RESULTSOverall survival (OS)and disease free survival (DFS)at 5 years for the cohort were (63.8 ± 5.6)% and (60.9 ± 5.6)%, respectively. The cumulative non-relapse mortality (NRM)and relapse at 5 years were (4.70 ± 0.05)% and (34.40 ± 0.31)%. For DFS, age ≥ 35 years, high lactate dehydrogenase at diagnosis, high initial WBC count, blast cell proportion ≥ 5% on 15th day of the first induction therapy, complete remession (CR)1 to HSCT interval >6 months and CD34⁺ cells in graft ≥ 3.8 × 10⁶/kg were the poor prognostic factors. CR1 to HSCT interval >6 months was the independently undesirable factors in COX regression model. For 34 patients who had results of minimal residual disease (MRD), positive pretransplantation MRD (MRD≥0.01%), positive post-induction MRD or MRD positive again during the chemotherapy indicated poor prognosis, and the last one was the independent adverse prognostic factor.
CONCLUSIONAuto-HSCT combined with post-transplantation maintenance chemotherapy could be an optional approach for adult B-ALL patients. MRD plays a significant role in the treatment choice for adult Ph-negative B-ALL patients.
Acute Disease ; Adult ; Disease-Free Survival ; Hematopoietic Stem Cell Transplantation ; Humans ; Maintenance Chemotherapy ; Neoplasm, Residual ; Precursor B-Cell Lymphoblastic Leukemia-Lymphoma ; therapy ; Recurrence ; Retrospective Studies ; Survival Rate
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