Reduced-intensity allogeneic stem cell transplantation for patients aged 50 years or older with B-cell ALL in remission: A retrospective study by the Adult ALL Working Group of the Japan Society for Hematopoietic Cell Transplantation

H. Kanamori, S. Mizuta, S. Kako, H. Kato, S. Nishiwaki, K. Imai, A. Shigematsu, H. Nakamae, M. Tanaka, K. Ikegame, T. Yujiri, T. Fukuda, K. Minagawa, T. Eto, T. Nagamura-Inoue, Y. Morishima, R. Suzuki, H. Sakamaki, J. Tanaka

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

We retrospectively assessed the outcome and pretransplantation predictors of the outcome in 118 patients aged ≥50 years who received fludarabine-containing reduced-intensity allo-SCT (RIST) for B-cell ALL in the first or second CR. Eighty patients received transplants from unrelated donors. Seventy-eight patients were positive for the Ph chromosome. The median follow-up period was 18 months and the 2-year OS rate was 56%. The 2-year cumulative incidence of relapse and non-relapse mortality was 28% and 26%, respectively. The incidence of grades II-IV and III-IV acute GVHD was 46% and 24%, respectively. After 2 years, the incidence of chronic GVHD was 37%. Multivariate analysis of pretransplant factors showed that a higher white blood cell count (≥30 × 10 9 /L) at diagnosis (hazard ratio (HR)=2.19, P=0.007) and second CR (HR=2.02, P=0.036) were significantly associated with worse OS, whereas second CR (HR=3.83, P<0.001) and related donor (HR=2.34, P=0.039) were associated with a higher incidence of relapse. Fludarabine-containing RIST may be a promising strategy for older patients with B-cell ALL in their first remission.

Original languageEnglish (US)
Pages (from-to)1513-1518
Number of pages6
JournalBone Marrow Transplantation
Volume48
Issue number12
DOIs
StatePublished - Dec 2013

Fingerprint

Cell Transplantation
Stem Cell Transplantation
Japan
B-Lymphocytes
Retrospective Studies
Incidence
Recurrence
Unrelated Donors
Leukocyte Count
Multivariate Analysis
Chromosomes
Tissue Donors
Transplants
Mortality
fludarabine

All Science Journal Classification (ASJC) codes

  • Hematology
  • Transplantation

Cite this

Kanamori, H. ; Mizuta, S. ; Kako, S. ; Kato, H. ; Nishiwaki, S. ; Imai, K. ; Shigematsu, A. ; Nakamae, H. ; Tanaka, M. ; Ikegame, K. ; Yujiri, T. ; Fukuda, T. ; Minagawa, K. ; Eto, T. ; Nagamura-Inoue, T. ; Morishima, Y. ; Suzuki, R. ; Sakamaki, H. ; Tanaka, J. / Reduced-intensity allogeneic stem cell transplantation for patients aged 50 years or older with B-cell ALL in remission : A retrospective study by the Adult ALL Working Group of the Japan Society for Hematopoietic Cell Transplantation. In: Bone Marrow Transplantation. 2013 ; Vol. 48, No. 12. pp. 1513-1518.
@article{028e5d5fd25f4a29b17fce3084278dc1,
title = "Reduced-intensity allogeneic stem cell transplantation for patients aged 50 years or older with B-cell ALL in remission: A retrospective study by the Adult ALL Working Group of the Japan Society for Hematopoietic Cell Transplantation",
abstract = "We retrospectively assessed the outcome and pretransplantation predictors of the outcome in 118 patients aged ≥50 years who received fludarabine-containing reduced-intensity allo-SCT (RIST) for B-cell ALL in the first or second CR. Eighty patients received transplants from unrelated donors. Seventy-eight patients were positive for the Ph chromosome. The median follow-up period was 18 months and the 2-year OS rate was 56{\%}. The 2-year cumulative incidence of relapse and non-relapse mortality was 28{\%} and 26{\%}, respectively. The incidence of grades II-IV and III-IV acute GVHD was 46{\%} and 24{\%}, respectively. After 2 years, the incidence of chronic GVHD was 37{\%}. Multivariate analysis of pretransplant factors showed that a higher white blood cell count (≥30 × 10 9 /L) at diagnosis (hazard ratio (HR)=2.19, P=0.007) and second CR (HR=2.02, P=0.036) were significantly associated with worse OS, whereas second CR (HR=3.83, P<0.001) and related donor (HR=2.34, P=0.039) were associated with a higher incidence of relapse. Fludarabine-containing RIST may be a promising strategy for older patients with B-cell ALL in their first remission.",
author = "H. Kanamori and S. Mizuta and S. Kako and H. Kato and S. Nishiwaki and K. Imai and A. Shigematsu and H. Nakamae and M. Tanaka and K. Ikegame and T. Yujiri and T. Fukuda and K. Minagawa and T. Eto and T. Nagamura-Inoue and Y. Morishima and R. Suzuki and H. Sakamaki and J. Tanaka",
year = "2013",
month = "12",
doi = "10.1038/bmt.2013.140",
language = "English (US)",
volume = "48",
pages = "1513--1518",
journal = "Bone Marrow Transplantation",
issn = "0268-3369",
publisher = "Nature Publishing Group",
number = "12",

}

Kanamori, H, Mizuta, S, Kako, S, Kato, H, Nishiwaki, S, Imai, K, Shigematsu, A, Nakamae, H, Tanaka, M, Ikegame, K, Yujiri, T, Fukuda, T, Minagawa, K, Eto, T, Nagamura-Inoue, T, Morishima, Y, Suzuki, R, Sakamaki, H & Tanaka, J 2013, 'Reduced-intensity allogeneic stem cell transplantation for patients aged 50 years or older with B-cell ALL in remission: A retrospective study by the Adult ALL Working Group of the Japan Society for Hematopoietic Cell Transplantation', Bone Marrow Transplantation, vol. 48, no. 12, pp. 1513-1518. https://doi.org/10.1038/bmt.2013.140

Reduced-intensity allogeneic stem cell transplantation for patients aged 50 years or older with B-cell ALL in remission : A retrospective study by the Adult ALL Working Group of the Japan Society for Hematopoietic Cell Transplantation. / Kanamori, H.; Mizuta, S.; Kako, S.; Kato, H.; Nishiwaki, S.; Imai, K.; Shigematsu, A.; Nakamae, H.; Tanaka, M.; Ikegame, K.; Yujiri, T.; Fukuda, T.; Minagawa, K.; Eto, T.; Nagamura-Inoue, T.; Morishima, Y.; Suzuki, R.; Sakamaki, H.; Tanaka, J.

In: Bone Marrow Transplantation, Vol. 48, No. 12, 12.2013, p. 1513-1518.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Reduced-intensity allogeneic stem cell transplantation for patients aged 50 years or older with B-cell ALL in remission

T2 - A retrospective study by the Adult ALL Working Group of the Japan Society for Hematopoietic Cell Transplantation

AU - Kanamori, H.

AU - Mizuta, S.

AU - Kako, S.

AU - Kato, H.

AU - Nishiwaki, S.

AU - Imai, K.

AU - Shigematsu, A.

AU - Nakamae, H.

AU - Tanaka, M.

AU - Ikegame, K.

AU - Yujiri, T.

AU - Fukuda, T.

AU - Minagawa, K.

AU - Eto, T.

AU - Nagamura-Inoue, T.

AU - Morishima, Y.

AU - Suzuki, R.

AU - Sakamaki, H.

AU - Tanaka, J.

PY - 2013/12

Y1 - 2013/12

N2 - We retrospectively assessed the outcome and pretransplantation predictors of the outcome in 118 patients aged ≥50 years who received fludarabine-containing reduced-intensity allo-SCT (RIST) for B-cell ALL in the first or second CR. Eighty patients received transplants from unrelated donors. Seventy-eight patients were positive for the Ph chromosome. The median follow-up period was 18 months and the 2-year OS rate was 56%. The 2-year cumulative incidence of relapse and non-relapse mortality was 28% and 26%, respectively. The incidence of grades II-IV and III-IV acute GVHD was 46% and 24%, respectively. After 2 years, the incidence of chronic GVHD was 37%. Multivariate analysis of pretransplant factors showed that a higher white blood cell count (≥30 × 10 9 /L) at diagnosis (hazard ratio (HR)=2.19, P=0.007) and second CR (HR=2.02, P=0.036) were significantly associated with worse OS, whereas second CR (HR=3.83, P<0.001) and related donor (HR=2.34, P=0.039) were associated with a higher incidence of relapse. Fludarabine-containing RIST may be a promising strategy for older patients with B-cell ALL in their first remission.

AB - We retrospectively assessed the outcome and pretransplantation predictors of the outcome in 118 patients aged ≥50 years who received fludarabine-containing reduced-intensity allo-SCT (RIST) for B-cell ALL in the first or second CR. Eighty patients received transplants from unrelated donors. Seventy-eight patients were positive for the Ph chromosome. The median follow-up period was 18 months and the 2-year OS rate was 56%. The 2-year cumulative incidence of relapse and non-relapse mortality was 28% and 26%, respectively. The incidence of grades II-IV and III-IV acute GVHD was 46% and 24%, respectively. After 2 years, the incidence of chronic GVHD was 37%. Multivariate analysis of pretransplant factors showed that a higher white blood cell count (≥30 × 10 9 /L) at diagnosis (hazard ratio (HR)=2.19, P=0.007) and second CR (HR=2.02, P=0.036) were significantly associated with worse OS, whereas second CR (HR=3.83, P<0.001) and related donor (HR=2.34, P=0.039) were associated with a higher incidence of relapse. Fludarabine-containing RIST may be a promising strategy for older patients with B-cell ALL in their first remission.

UR - http://www.scopus.com/inward/record.url?scp=84889606772&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84889606772&partnerID=8YFLogxK

U2 - 10.1038/bmt.2013.140

DO - 10.1038/bmt.2013.140

M3 - Article

C2 - 24056740

AN - SCOPUS:84889606772

VL - 48

SP - 1513

EP - 1518

JO - Bone Marrow Transplantation

JF - Bone Marrow Transplantation

SN - 0268-3369

IS - 12

ER -