Improvements in allogeneic hematopoietic cell transplantation outcomes for adults with ALL over the past 3 decades

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  • Satoshi Nishiwaki
    1Department of Advanced Medicine, Nagoya University Hospital, Nagoya, Japan;
  • Yu Akahoshi
    2Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan;
  • Mari Morita-Fujita
    4Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan;
  • Hiroaki Shimizu
    5Division of Hematology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan;
  • Naoyuki Uchida
    6Department of Hematology, Federation of National Public Service Personnel Mutual Aid Associations Toranomon Hospital, Tokyo, Japan;
  • Yukiyasu Ozawa
    7Department of Hematology, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Nagoya, Japan;
  • Takahiro Fukuda
    8Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan;
  • Masatsugu Tanaka
    9Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan;
  • Kazuhiro Ikegame
    10Department of Hematology, Hyogo College of Medicine Hospital, Nishinomiya, Japan;
  • Shuichi Ota
    11Department of Hematology, Sapporo Hokuyu Hospital, Sapporo, Japan;
  • Yuta Katayama
    12Department of Hematology, Hiroshima Red Cross Hospital & Atomic-Bomb Survivors Hospital, Hiroshima, Japan;
  • Satoshi Takahashi
    13Division of Clinical Precision Research Platform, the Institute of Medical Science, the University of Tokyo, Tokyo, Japan;
  • Toshiro Kawakita
    14Department of Hematology, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan;
  • Takahide Ara
    15Department of Hematology, Hokkaido University Hospital, Sapporo, Japan;
  • Makoto Onizuka
    16Department of Hematology/Oncology, Tokai University School of Medicine, Isehara, Japan;
  • Takafumi Kimura
    17Preparation Department, Japanese Red Cross Kinki Block Blood Center, Ibaraki, Japan;
  • Junji Tanaka
    18Department of Hematology, Tokyo Women’s Medical University, Tokyo, Japan;
  • Yoshiko Atsuta
    19Japanese Data Center for Hematopoietic Cell Transplantation, Nagakute, Japan; and
  • Yasuyuki Arai
    4Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan;

抄録

<jats:title>Abstract</jats:title> <jats:p>Allogeneic hematopoietic cell transplantation (allo-HCT) is a promising treatment for adult acute lymphoblastic leukemia (ALL), an intractable hematological malignancy. The trends in allo-HCT outcomes over the past 30 years were examined to verify the efficacy of evolving treatment methods and to identify further challenges. We analyzed data from a registry database that included 8467 adult ALL patients who underwent their first allo-HCT between 1990 and 2019. The period was divided into three 10-year intervals for analysis. Five-year overall survival improved from 48.2% to 70.2% in the first complete remission (CR1), from 25.6% to 44.1% in subsequent CR, and from 10.0% to 22.7% in non-CR. Nonrelapse mortality improved over the 3 decades in each disease stage. However, the relapse rate only improved in CR1 every decade (26.3% to 15.9% in CR1, 33.4% to 32.8% in subsequent CR, and 53.6% to 54.8% in non-CR). Although there were continual improvements in adjusted survival for Philadelphia chromosome (Ph)-positive patients, the improvement was inadequate for Ph− patients with t(4;11), t(8;14), t(14;18), or hypodiploidy. Allo-HCT outcomes for adults with ALL have improved over the past 30 years. Improved outcomes in the future will require more effective prevention of relapse in patients with ALL not in CR1 and in those with high-risk chromosomal abnormalities.</jats:p>

収録刊行物

  • Blood Advances

    Blood Advances 6 (15), 4558-4569, 2022-08-04

    American Society of Hematology

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