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Pretransplant Consolidation Is Not Beneficial for Adults with ALL Undergoing Myeloablative Allogeneic Transplantation
Univ Minnesota, Div Hematol Oncol & Transplantat, 420 Delaware St SE,Mayo Mail Code 480, Minneapolis, MN 55455 USA.
Med Coll Wisconsin, Inst Hlth & Soc, Div Biostat, Milwaukee, WI 53226 USA;Med Coll Wisconsin, Dept Med, CIBMTR Ctr Int Blood & Marrrow Trasnsplantat, Milwaukee, WI 53226 USA.
Med Coll Wisconsin, Dept Med, CIBMTR Ctr Int Blood & Marrrow Trasnsplantat, Milwaukee, WI 53226 USA.
Univ Minnesota, Div Hematol Oncol & Transplantat, 420 Delaware St SE,Mayo Mail Code 480, Minneapolis, MN 55455 USA.
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2018 (English)In: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 24, no 5, p. 945-955Article in journal (Refereed) Published
Abstract [en]

Allogeneic hematopoietic cell transplantation (alloHCT) is curative for patients with acute lymphoblastic leukemia (ALL) who achieve complete remission (CR1) with chemotherapy. However, the benefit of consolidation chemotherapy remains uncertain in patients undergoing alloHCT. We compared clinical outcomes of 524 adult patients with ALL in CR1 who received ≥2 (n = 109), 1 (n = 93), or 0 cycles (n = 322) of consolidation before myeloablative alloHCT from 2008 to 2012. As expected, time to alloHCT was longer with increasing cycles of consolidation. Patients receiving ≥2, 1, or 0 cycles of consolidation had an adjusted 3-year cumulative incidence of relapse of 20%, 27%, and 22%; 1-year transplant-related mortality (TRM) of 16%, 18%, and 23%; adjusted 3-year leukemia-free survival (LFS) of 54%, 48%, and 47%; and 3-year overall survival (OS) of 63%, 59%, and 54% (all P values >.40). Multivariable analysis confirmed that consolidation was not prognostic for LFS (relative risk, 1.20, 95% confidence interval, .86 to 1.67; P = .28 for no consolidation; RR, 1.18, 95% confidence interval, .79 to 1.76; P = .41 for 1 cycle versus ≥2 cycles = reference). Similarly, consolidation was not associated with OS, relapse, TRM, or graft-versus-host disease. We conclude that consolidation chemotherapy does not appear to provide added benefit in adult ALL patients with available donors who undergo myeloablative alloHCT in CR1.

Place, publisher, year, edition, pages
2018. Vol. 24, no 5, p. 945-955
Keywords [en]
ALL, Consolidation chemotherapy, Myeloablative.conditioning, Allogeneic transplant
National Category
Hematology
Identifiers
URN: urn:nbn:se:uu:diva-357580DOI: 10.1016/j.bbmt.2017.12.784ISI: 000433400000010PubMedID: 29275139OAI: oai:DiVA.org:uu-357580DiVA, id: diva2:1239802
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AstraZenecaAvailable from: 2018-08-17 Created: 2018-08-17 Last updated: 2018-08-17Bibliographically approved

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Olsson, Richard

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