The role of allogeneic bone marrow transplantation in adult patients below the age of 55 years with acute lymphoblastic leukemia in first complete remission: a donor vs no donor comparison

Gupta, Vikas; Yi, Q-L.; Brandwein, Joseph; Minden, Mark D.; Schuh, Andre C.; Wells, Richard A.; Chun, Kathy; Kamel‐Reid, Suzanne; Tsang, Richard W.; Daly, Andrew; Kiss, Thomas; Lipton, Jeffrey H.; Messner, Hans A.

doi:10.1038/sj.bmt.1704368

Cited by 42 publications

(32 citation statements)

References 31 publications

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“…Only seven clinical trials [1][2][3][19][20][21][22] met the criteria set by Phase 1 of our meta-analysis protocol. In Phase 2, we first excluded the trial by Hallbook et al 20 (in which the subjects were given either autologous or allogeneic transplantation according to no pre-specified criteria and without using an intention-to-treat design).…”

Section: Clinical Materialsmentioning

confidence: 99%

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Event-free survival and cost-effectiveness in adult acute lymphoblastic leukaemia in first remission treated with allogeneic transplantation

Orsi

Bartolozzi

Messori

et al. 2007

Bone Marrow Transplant

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Allogeneic transplantation in patients with acute lymphoblastic leukaemia in first remission (ALL-CR1) has been studied in several clinical trials. However, no pooled survival analysis has yet been done. We conducted a survival meta-analysis to compare allogeneic transplantation vs chemotherapy or autologous transplantation using an intention-to-treat approach. Our study included the controlled clinical trials, wherein allocation to allogeneic transplant was based on donor availability. The event-free individual survival data were reconstructed on the basis of published information and Kaplan-Meier graphs. We then generated the meta-analytic event-free survival curves for the two treatments. The mean survival gain per patient was estimated and a simplified cost-effectiveness assessment was carried out. In the allogeneic transplantation group, 293 patients were examined and 479 as controls (four trials). The event-free survival difference was statistically significant (P ¼ 0.011). The relative risk for event occurrence was 0.79 for the experimental group vs the controls (95% CI: 0.66-0.96; P ¼ 0.017). The mean survival gain was 1 year per patient. The cost per life-year gained was less than the conventional threshold of h50 000. Allogeneic transplantation in ALL-CR1 improves event-free survival as compared to chemotherapy or autologous transplantation. Its cost-effectiveness profile is acceptable.

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Section: Clinical Materialsmentioning

confidence: 99%

“…With induction treatment, 80-90% of patients achieve CR, but the majority relapse and so the long-term event-free survival is only 30-35%. [1][2][3][4][5] Thus, selecting optimal post-remission treatments is still a matter of debate.…”

Section: Introductionmentioning

confidence: 99%

Event-free survival and cost-effectiveness in adult acute lymphoblastic leukaemia in first remission treated with allogeneic transplantation

Orsi

Bartolozzi

Messori

et al. 2007

Bone Marrow Transplant

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“…Transfusion and other supportive care were also carried out as earlier described. 23,24 Patients who received Alemtuzumab as part of their GVHD prophylaxis also received 3 months of antifungal prophylaxis (voriconazle, itraconazole or posaconazole) and antiviral prophylaxis (acyclovir). Post transplant G-CSF was not routinely administered.…”

Section: Treatmentmentioning

confidence: 99%

Impact of intensity of conditioning therapy in patients aged 40–60 years with AML/myelodysplastic syndrome undergoing allogeneic transplantation

Khabori

Elemary

et al. 2010

Bone Marrow Transplant

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The optimum intensity of conditioning therapy in patients aged 40-60 years with AML and myelodysplastic syndrome (MDS) undergoing allogeneic haematopoietic cell transplantation (alloHCT) remains uncertain. We compared outcomes of reduced intensity conditioning (RIC) and conventional intensity conditioning (CIC) in 101consecutive patients (CIC, 62; RIC, 39) with AML and MDS aged 40-60 years undergoing alloHCT from 2002 to 2008 at our centre. The median age, unrelated transplants and co-morbidity index were higher in the RIC group. Median OS and EFS were 31.0 months (95% confidence interval (CI): 12.8-59.3) and 20.7 months (95% CI: 11.0-30.4), respectively, with no significant difference between the two cohorts. The 3-year treatmentrelated mortality (TRM) and relapse were 28% (95% CI: 21-39) and 25% (95% CI: 17-36), respectively, with no significant difference between the two cohorts. No difference in OS, EFS, TRM or relapse was observed between the two cohorts in the multivariate model. Only disease risk was significantly associated with OS (Hazard ratio (HR): 1.85, CI: 1.01-3.45), EFS (HR: 1.73, 95% CI: 1.00-3.10) and cumulative relapse (HR: 3.24, 95% CI: 1.08-10.12). Disease biology rather than intensity of conditioning regimen seems to determine outcomes of alloHCT in patients aged 40-60 years with AML/MDS.

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“…[1][2][3][4] However, there are lack of information on long-term follow-up and complications in these patients. The patients treated with alloBMT or chemotherapy alone may have a different spectrum of long-term complications.…”

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confidence: 99%

“…2 According to the institutional policy, these patients were offered alloBMT in first CR if a related donor was available. Unrelated donor transplants were offered to Ph positive ALL (Ph þ ALL) patients.…”

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confidence: 99%

Long-term outcomes in adult patients below the age of 55 years with acute lymphoblastic leukemia treated with chemotherapy or allogeneic BM transplant in first CR

Kohli

Brandwein

et al. 2009

Bone Marrow Transplant

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The role of allogeneic bone marrow transplantation in adult patients below the age of 55 years with acute lymphoblastic leukemia in first complete remission: a donor vs no donor comparison

Abstract: Acute lymphoblastic leukemiaThe role of allogeneic bone marrow transplantation in adult patients below the age of 55 years with acute lymphoblastic leukemia in first complete remission: a donor vs no donor comparison

Cited by 42 publications

References 31 publications

Event-free survival and cost-effectiveness in adult acute lymphoblastic leukaemia in first remission treated with allogeneic transplantation

Event-free survival and cost-effectiveness in adult acute lymphoblastic leukaemia in first remission treated with allogeneic transplantation

Impact of intensity of conditioning therapy in patients aged 40–60 years with AML/myelodysplastic syndrome undergoing allogeneic transplantation

Long-term outcomes in adult patients below the age of 55 years with acute lymphoblastic leukemia treated with chemotherapy or allogeneic BM transplant in first CR

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