Autologous and allogeneic stem cell transplantation in adult ALL: the Swedish Adult ALL Group experience

Research output: Contribution to journalArticle

Abstract

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 counterbalanced 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.

Details

Authors
  • H Hallbook
  • H Hagglund
  • D Stockelberg
  • Per-Gunnar Nilsson
  • Karin Karlsson
  • M Bjorkholm
  • M Linderholm
  • A Wahlin
  • O Linder
  • B Smedmyr
Organisations
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Hematology

Keywords

  • stem cell transplantation, acute lymphoblastic leukaemia, adults, versus host disease, graft
Original languageEnglish
Pages (from-to)1141-1148
JournalBone Marrow Transplantation
Volume35
Issue number12
Publication statusPublished - 2005
Publication categoryResearch
Peer-reviewedYes

Bibliographic note

The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Hematology/Transplantation (013022014), Division of Hematology and Transfusion Medicine (013041100)