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Autologous and allogeneic stem cell transplantation in adult ALL: The Swedish Adult ALL Group experience
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2005 (English)In: Bone Marrow Transplantation, ISSN 0268-3369, Vol. 35, no 12, 1141-1148 p.Article in journal (Refereed) Published
Abstract [en]

Adult patients with acute lymphoblastic leukaemia (ALL) have been treated according to national protocols in Sweden since 1986. Stem cell transplantation (SCT) has been recommended in first remission for patients with risk factors for relapse, and for standard risk patients only after relapse. In this retrospective study, the results of autologous and allogeneic SCT in these populations were evaluated. In total, 187 patients with a median age of 34 years (17-66 years) underwent SCT. The 5-year disease-free survival (DFS), for all patients, was 26% (Confidence intervals (CI) 20-32%). The 5-year DFS was higher for patients transplanted in first remission 32% (CI 24-40%) compared to 14% (CI 5-23%, P<0.0001) in patients transplanted beyond first remission. No significant differences in DFS (P = 0.06) were determined between autologous, related donor and unrelated donor SCT in the whole cohort. A lower relapse rate was counter-balanced by higher treatment-related mortality in patients undergoing allogeneic SCT. In Philadelphia-positive ALL, allogeneic SCT was superior to autologous SCT, with a 5-year DFS of 30% (CI 12-47%) vs 0% (P = 0.04). Limited chronic graft-versus-host-disease (GVHD) was associated with an improved DFS of 53% (CI 38-69%) compared to no chronic GVHD of 22% (CI 10-36%, P = 0.0008), indicating a clinically important graft-versus-leukaemia effect. © 2005 Nature Publishing Group All rights reserved.

Place, publisher, year, edition, pages
2005. Vol. 35, no 12, 1141-1148 p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-33254DOI: 10.1038/sj.bmt.1704974Local ID: 19253OAI: diva2:254077
Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2011-01-12

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Faculty of Health SciencesOncologyDepartment of Haematology UHL
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