Impact of transplant eligibility and availability of a human leukocyte antigen-identical matched related donor on outcome of older patients with acute lymphoblastic leukemia

Pere Barba, Rodrigo Martino, David Martinez-Cuadron, García Olga, Albert Esquirol, Cristina Gil-Cortés, José Gonzalez, Francesc Fernandez-Avilés, David Valcárcel, Ramón Guardia, Rafael F. Duarte, Jesús Maria Hernandez-Rivas, Eugenia Abella, Pau Montesinos, Josep Maria Ribera

Research output: Contribution to journalArticleResearchpeer-review

4 Citations (Scopus)

Abstract

© 2015 Informa UK, Ltd. The role of allogeneic hematopoietic cell transplant (allo-HCT) in elderly patients with acute lymphoblastic leukemia (ALL) is unclear. We conducted a prospective study including 110 homogeneously treated patients with ALL aged 50-70 years. Their outcomes were analyzed by intention-to-treat on a donor-versus-no donor basis. Fifty-five patients (50%) underwent human leukocyte antigen (HLA) typing and were considered potential allo-HCT candidates, although only 25 (23%) eventually received an allo-HCT. Among potential allo-HCT candidates, patients with (n = 28) and without (n = 27) an HLA-identical sibling showed similar leukemia-free survival, overall survival (OS) and relapse risk, and the only variable associated with a better outcome was achievement of first complete remission (CR1) after induction therapy. Among the 25 patients who actually received an allo-HCT, the 4-year non-relapse mortality and OS were 42% (95% confidence interval 31-53%) and 37% (95% confidence interval 27-47%), respectively. In conclusion, having an HLA-identical sibling donor was not associated with a better outcome in patients with ALL aged 50-70 years.
Original languageEnglish
Pages (from-to)2812-2818
JournalLeukemia and Lymphoma
Volume56
Issue number10
DOIs
Publication statusPublished - 1 Jan 2015

Keywords

  • acute lymphoblastic leukemia
  • Allogeneic transplant
  • HCT
  • RIC

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