International Journal of Hematology

DOI: 10.1007/s12185-015-1883-0 Pages: 689-696

Effects of conditioning intensity in allogeneic stem cell transplantation for Philadelphia chromosome-positive acute lymphoblastic leukemia

1. Kyushu University, Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences

2. Harasanshin Hospital, Department of Hematology

3. Hamanomachi Hospital, Department of Hematology

4. Kyushu University Beppu Hospital, Department of Internal Medicine

5. Kitakyushu Municipal Medical Center, Department of Internal Medicine

6. Kurume University School of Medicine, Department of Medicine, Division of Hematology and Oncology

7. Hokkaido University Graduate School of Medicine, Department of Hematology

Correspondence to:
Toshihiro Miyamoto
Tel: +81-92-642-5230
Email: toshmiya@intmed1.med.kyushu-u.ac.jp

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Abstract

We retrospectively analyzed the outcomes of patients with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ALL) who underwent first allogeneic stem cell transplantation (allo-SCT) at complete remission (CR) with myeloablative conditioning (MAC, n = 31) or reduced-intensity conditioning (RIC, n = 15) between 2001 and 2012. All the patients had received tyrosine kinase inhibitor (TKI)-based chemotherapy prior to allo-SCT. Overall survival (OS) rates (57 vs 63 %, p = 0.53), leukemia-free survival rates (50 vs 65 %, p = 0.29), and non-relapse mortality rates (39 vs 35 %, p = 0.62) at 2 years were similar between the MAC and RIC groups. The minimal residual disease (MRD) status evaluated by sensitive polymerase chain reaction prior to allo-SCT did not influence the OS rate (77 vs 54 %, p = 0.28) and leukemia-free survival rate (69 vs 51 %, p = 0.48), irrespective of the conditioning intensity. Our data suggest that the RIC regimen may represent a sufficient intensity of therapeutic pre-transplant conditioning for patients with Ph+ALL who have maintained a hematological CR with TKI-combined chemotherapy.

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