Ph+ ALL patients in first complete remission have similar survival after reduced intensity and myeloablative allogeneic transplantation: Impact of tyrosine kinase inhibitor and minimal residual disease
Identifieur interne : 002C46 ( Pmc/Curation ); précédent : 002C45; suivant : 002C47Ph+ ALL patients in first complete remission have similar survival after reduced intensity and myeloablative allogeneic transplantation: Impact of tyrosine kinase inhibitor and minimal residual disease
Auteurs : Veronika Bachanova [États-Unis] ; David I. Marks [Royaume-Uni] ; Mei-Jie Zhang [États-Unis] ; Hailin Wang [États-Unis] ; Marcos De Lima [États-Unis] ; Mahmoud D. Aljurf [Arabie saoudite] ; Martha Arellano [États-Unis] ; Andrew S. Artz [États-Unis] ; Ulrike Bacher [Allemagne] ; Jean-Yves Cahn [France] ; Yi-Bin Chen [États-Unis] ; Edward A. Copelan [États-Unis] ; William R. Drobyski [États-Unis] ; Robert Peter Gale [Royaume-Uni] ; John P. Greer [États-Unis] ; Vikas Gupta [Canada] ; Gregory A. Hale [États-Unis] ; Partow Kebriaei [États-Unis] ; Hillard M. Lazarus [États-Unis] ; Ian D. Lewis [Australie] ; Victor A. Lewis [Canada] ; Jane L. Liesveld [États-Unis] ; Mark R. Litzow [États-Unis] ; Alison W. Loren [États-Unis] ; Alan M. Miller [États-Unis] ; Maxim Norkin [États-Unis] ; Betul Oran [États-Unis] ; Joseph Pidala [États-Unis] ; Jacob M. Rowe [Israël] ; Bipin N. Savani [États-Unis] ; Wael Saber [États-Unis] ; Ravi Vij [États-Unis] ; Edmund K. Waller [États-Unis] ; Peter H. Wiernik [États-Unis] ; Daniel J. Weisdorf [États-Unis]Source :
- Leukemia [ 0887-6924 ] ; 2013.
Abstract
The efficacy of reduced intensity conditioning (RIC) allogeneic hematopoietic cell transplantation (HCT) for Ph+ acute lymphoblastic leukemia (ALL) is uncertain. We analyzed 197 adults with Ph+ ALL in first complete remission; 67 patients receiving RIC were matched with 130 receiving myeloablative conditioning (MAC) for age, donor type, and HCT year. Over 75% received pre-HCT tyrosine kinase inhibitors (TKI), mostly imatinib; 39% (RIC) and 49% (MAC) were MRDneg pre-HCT. At a median 4.5 years follow-up, 1-year transplant-related mortality (TRM) was lower in RIC (13%) than MAC (36%;p=0.001) while the 3-year relapse rate was 49% in RIC and 28% in MAC (p=0.058). Overall survival was similar (RIC 39% [95% CI:27–52] vs. 35% [95% CI:270–44];p=0.62). Patients MRDpos pre-HCT had higher risk of relapse with RIC versus MAC (HR 1.97;p=0.026). However, patients receiving pre-HCT TKI in combination with MRD negativity pre-RIC HCT had superior OS (55%) compared to a similar MRDneg population after MAC (33%; p=0.0042). In multivariate analysis, RIC lowered TRM (HR 0.6; p=0.057), but absence of pre-HCT TKI (HR 1.88;p=0.018), RIC (HR 1.891;p=0.054) and pre-HCT MRDpos (HR 1.6; p=0.070) increased relapse risk. RIC is a valid alternative strategy for Ph+ ALL patients ineligible for MAC and MRDneg status is preferred pre-HCT.
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DOI: 10.1038/leu.2013.253
PubMed: 23989431
PubMed Central: 3951192
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Aljurf</name><affiliation wicri:level="1"><nlm:aff id="A5">King Faisal Specialist Hospital and Research Center, Riyadh, SAUDI ARABIA</nlm:aff><country xml:lang="fr" wicri:curation="lc">Arabie saoudite</country><wicri:regionArea>King Faisal Specialist Hospital and Research Center, Riyadh</wicri:regionArea></affiliation></author><author><name sortKey="Arellano, Martha" sort="Arellano, Martha" uniqKey="Arellano M" first="Martha" last="Arellano">Martha Arellano</name><affiliation wicri:level="2"><nlm:aff id="A6">Winship Cancer Institute, Emory University, Atlanta, GA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Géorgie (États-Unis)</region></placeName><wicri:cityArea>Winship Cancer Institute, Emory University, Atlanta</wicri:cityArea></affiliation></author><author><name sortKey="Artz, Andrew S" sort="Artz, Andrew S" uniqKey="Artz A" first="Andrew S." last="Artz">Andrew S. Artz</name><affiliation wicri:level="2"><nlm:aff id="A7">University of Chicago Medicine, Chicago, IL</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Illinois</region></placeName><wicri:cityArea>University of Chicago Medicine, Chicago</wicri:cityArea></affiliation></author><author><name sortKey="Bacher, Ulrike" sort="Bacher, Ulrike" uniqKey="Bacher U" first="Ulrike" last="Bacher">Ulrike Bacher</name><affiliation wicri:level="1"><nlm:aff id="A8">Klinik und Poliklinik fur Stammzelltransplantation, Universitatsklinikum Hamburg-Eppendorf, Hamburg, GERMANY</nlm:aff><country xml:lang="fr" wicri:curation="lc">Allemagne</country><wicri:regionArea>Klinik und Poliklinik fur Stammzelltransplantation, Universitatsklinikum Hamburg-Eppendorf, Hamburg</wicri:regionArea></affiliation></author><author><name sortKey="Cahn, Jean Yves" sort="Cahn, Jean Yves" uniqKey="Cahn J" first="Jean-Yves" last="Cahn">Jean-Yves Cahn</name><affiliation wicri:level="1"><nlm:aff id="A9">Department of Hematology, University Hospital, Grenoble, FRANCE</nlm:aff><country xml:lang="fr" wicri:curation="lc">France</country><wicri:regionArea>Department of Hematology, University Hospital, Grenoble</wicri:regionArea></affiliation></author><author><name sortKey="Chen, Yi Bin" sort="Chen, Yi Bin" uniqKey="Chen Y" first="Yi-Bin" last="Chen">Yi-Bin Chen</name><affiliation wicri:level="2"><nlm:aff id="A10">Massachusetts General Hospital, Boston, MA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Massachusetts</region></placeName><wicri:cityArea>Massachusetts General Hospital, Boston</wicri:cityArea></affiliation></author><author><name sortKey="Copelan, Edward A" sort="Copelan, Edward A" uniqKey="Copelan E" first="Edward A." last="Copelan">Edward A. Copelan</name><affiliation wicri:level="2"><nlm:aff id="A11">Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Caroline du Nord</region></placeName><wicri:cityArea>Levine Cancer Institute, Carolinas HealthCare System, Charlotte</wicri:cityArea></affiliation></author><author><name sortKey="Drobyski, William R" sort="Drobyski, William R" uniqKey="Drobyski W" first="William R." last="Drobyski">William R. Drobyski</name><affiliation wicri:level="2"><nlm:aff id="A12">Medical College of Wisconsin, Milwaukee, WI</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Wisconsin</region></placeName><wicri:cityArea>Medical College of Wisconsin, Milwaukee</wicri:cityArea></affiliation></author><author><name sortKey="Gale, Robert Peter" sort="Gale, Robert Peter" uniqKey="Gale R" first="Robert Peter" last="Gale">Robert Peter Gale</name><affiliation wicri:level="1"><nlm:aff id="A13">Imperial College, Section of Hematology, Division of Experimental Medicine, Department of Medicine, London, UNITED KINGDOM</nlm:aff><country xml:lang="fr" wicri:curation="lc">Royaume-Uni</country><wicri:regionArea>Imperial College, Section of Hematology, Division of Experimental Medicine, Department of Medicine, London</wicri:regionArea></affiliation></author><author><name sortKey="Greer, John P" sort="Greer, John P" uniqKey="Greer J" first="John P" last="Greer">John P. Greer</name><affiliation wicri:level="2"><nlm:aff id="A14">Vanderbilt University Medical Center, Nashville, TN</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Tennessee</region></placeName><wicri:cityArea>Vanderbilt University Medical Center, Nashville</wicri:cityArea></affiliation></author><author><name sortKey="Gupta, Vikas" sort="Gupta, Vikas" uniqKey="Gupta V" first="Vikas" last="Gupta">Vikas Gupta</name><affiliation wicri:level="1"><nlm:aff id="A15">Princess Margaret Hospital, Toronto, ON, CANADA</nlm:aff><country xml:lang="fr" wicri:curation="lc">Canada</country><wicri:regionArea>Princess Margaret Hospital, Toronto, ON</wicri:regionArea></affiliation></author><author><name sortKey="Hale, Gregory A" sort="Hale, Gregory A" uniqKey="Hale G" first="Gregory A." last="Hale">Gregory A. Hale</name><affiliation wicri:level="2"><nlm:aff id="A16">All Children’s Hospital, St. Petersburg, FL</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Floride</region></placeName><wicri:cityArea>All Children’s Hospital, St. Petersburg</wicri:cityArea></affiliation></author><author><name sortKey="Kebriaei, Partow" sort="Kebriaei, Partow" uniqKey="Kebriaei P" first="Partow" last="Kebriaei">Partow Kebriaei</name><affiliation wicri:level="2"><nlm:aff id="A17">Stem Cell Transplantation and Cellular Therapy, MD Anderson Cancer Center, Houston, TX</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Stem Cell Transplantation and Cellular Therapy, MD Anderson Cancer Center, Houston</wicri:cityArea></affiliation></author><author><name sortKey="Lazarus, Hillard M" sort="Lazarus, Hillard M" uniqKey="Lazarus H" first="Hillard M." last="Lazarus">Hillard M. Lazarus</name><affiliation wicri:level="2"><nlm:aff id="A4">Seidman Cancer Center, University Hospitals Case Medical Center, Cleveland, OH</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Ohio</region></placeName><wicri:cityArea>Seidman Cancer Center, University Hospitals Case Medical Center, Cleveland</wicri:cityArea></affiliation></author><author><name sortKey="Lewis, Ian D" sort="Lewis, Ian D" uniqKey="Lewis I" first="Ian D." last="Lewis">Ian D. Lewis</name><affiliation wicri:level="1"><nlm:aff id="A18">Haematology and Bone Marrow Transplant Unit, Royal Adelaide Hospital/SA Pathology, Adelaide, AUSTRALIA</nlm:aff><country xml:lang="fr" wicri:curation="lc">Australie</country><wicri:regionArea>Haematology and Bone Marrow Transplant Unit, Royal Adelaide Hospital/SA Pathology, Adelaide</wicri:regionArea></affiliation></author><author><name sortKey="Lewis, Victor A" sort="Lewis, Victor A" uniqKey="Lewis V" first="Victor A." last="Lewis">Victor A. Lewis</name><affiliation wicri:level="1"><nlm:aff id="A19">Alberta Children’s Hospital, Calgary, AB, CANADA</nlm:aff><country xml:lang="fr" wicri:curation="lc">Canada</country><wicri:regionArea>Alberta Children’s Hospital, Calgary, AB</wicri:regionArea></affiliation></author><author><name sortKey="Liesveld, Jane L" sort="Liesveld, Jane L" uniqKey="Liesveld J" first="Jane L." last="Liesveld">Jane L. Liesveld</name><affiliation wicri:level="2"><nlm:aff id="A20">Strong Memorial Hospital, University of Rochester Medical Center; Rochester, NY</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">État de New York</region></placeName><wicri:cityArea>Strong Memorial Hospital, University of Rochester Medical Center; Rochester</wicri:cityArea></affiliation></author><author><name sortKey="Litzow, Mark R" sort="Litzow, Mark R" uniqKey="Litzow M" first="Mark R." last="Litzow">Mark R. Litzow</name><affiliation wicri:level="2"><nlm:aff id="A21">Hematology and Internal Medicine, Mayo Clinic Rochester, Rochester, MN</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Minnesota</region></placeName><wicri:cityArea>Hematology and Internal Medicine, Mayo Clinic Rochester, Rochester</wicri:cityArea></affiliation></author><author><name sortKey="Loren, Alison W" sort="Loren, Alison W" uniqKey="Loren A" first="Alison W." last="Loren">Alison W. Loren</name><affiliation wicri:level="2"><nlm:aff id="A22">Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>Perelman School of Medicine at the University of Pennsylvania, Philadelphia</wicri:cityArea></affiliation></author><author><name sortKey="Miller, Alan M" sort="Miller, Alan M" uniqKey="Miller A" first="Alan M." last="Miller">Alan M. Miller</name><affiliation wicri:level="2"><nlm:aff id="A23">Baylor University Medical Center, Dallas, TX</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Baylor University Medical Center, Dallas</wicri:cityArea></affiliation></author><author><name sortKey="Norkin, Maxim" sort="Norkin, Maxim" uniqKey="Norkin M" first="Maxim" last="Norkin">Maxim Norkin</name><affiliation wicri:level="2"><nlm:aff id="A24">Shands HealthCare and University of Florida, Gainesville, FL</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Floride</region></placeName><wicri:cityArea>Shands HealthCare and University of Florida, Gainesville</wicri:cityArea></affiliation></author><author><name sortKey="Oran, Betul" sort="Oran, Betul" uniqKey="Oran B" first="Betul" last="Oran">Betul Oran</name><affiliation wicri:level="2"><nlm:aff id="A17">Stem Cell Transplantation and Cellular Therapy, MD Anderson Cancer Center, Houston, TX</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Stem Cell Transplantation and Cellular Therapy, MD Anderson Cancer Center, Houston</wicri:cityArea></affiliation></author><author><name sortKey="Pidala, Joseph" sort="Pidala, Joseph" uniqKey="Pidala J" first="Joseph" last="Pidala">Joseph Pidala</name><affiliation wicri:level="2"><nlm:aff id="A25">Blood and Marrow Transplantation, Moffitt Cancer Center, Tampa, FL</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Floride</region></placeName><wicri:cityArea>Blood and Marrow Transplantation, Moffitt Cancer Center, Tampa</wicri:cityArea></affiliation></author><author><name sortKey="Rowe, Jacob M" sort="Rowe, Jacob M" uniqKey="Rowe J" first="Jacob M." last="Rowe">Jacob M. Rowe</name><affiliation wicri:level="1"><nlm:aff id="A26">Department of Hematology, Rambam Medical Center, Haifa, ISRAEL</nlm:aff><country xml:lang="fr" wicri:curation="lc">Israël</country><wicri:regionArea>Department of Hematology, Rambam Medical Center, Haifa</wicri:regionArea></affiliation></author><author><name sortKey="Savani, Bipin N" sort="Savani, Bipin N" uniqKey="Savani B" first="Bipin N." last="Savani">Bipin N. Savani</name><affiliation wicri:level="2"><nlm:aff id="A14">Vanderbilt University Medical Center, Nashville, TN</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Tennessee</region></placeName><wicri:cityArea>Vanderbilt University Medical Center, Nashville</wicri:cityArea></affiliation></author><author><name sortKey="Saber, Wael" sort="Saber, Wael" uniqKey="Saber W" first="Wael" last="Saber">Wael Saber</name><affiliation wicri:level="2"><nlm:aff id="A3">Center for International Blood and Marrow Transplant Research (CIBMTR), Medical College of Wisconsin, Milwaukee, WI</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Wisconsin</region></placeName><wicri:cityArea>Center for International Blood and Marrow Transplant Research (CIBMTR), Medical College of Wisconsin, Milwaukee</wicri:cityArea></affiliation></author><author><name sortKey="Vij, Ravi" sort="Vij, Ravi" uniqKey="Vij R" first="Ravi" last="Vij">Ravi Vij</name><affiliation wicri:level="2"><nlm:aff id="A27">Barnes Jewish Hospital, Washington University School of Medicine, St. Louis, MO</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Missouri (État)</region></placeName><wicri:cityArea>Barnes Jewish Hospital, Washington University School of Medicine, St. Louis</wicri:cityArea></affiliation></author><author><name sortKey="Waller, Edmund K" sort="Waller, Edmund K" uniqKey="Waller E" first="Edmund K." last="Waller">Edmund K. Waller</name><affiliation wicri:level="2"><nlm:aff id="A28">Bone Marrow and Stem Cell Transplant Center, Emory University Hospital, Atlanta, GA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Géorgie (États-Unis)</region></placeName><wicri:cityArea>Bone Marrow and Stem Cell Transplant Center, Emory University Hospital, Atlanta</wicri:cityArea></affiliation></author><author><name sortKey="Wiernik, Peter H" sort="Wiernik, Peter H" uniqKey="Wiernik P" first="Peter H." last="Wiernik">Peter H. Wiernik</name><affiliation wicri:level="2"><nlm:aff id="A29">Our Lady of Mercy Medical Center, Bronx, NY</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">État de New York</region></placeName><wicri:cityArea>Our Lady of Mercy Medical Center, Bronx</wicri:cityArea></affiliation></author><author><name sortKey="Weisdorf, Daniel J" sort="Weisdorf, Daniel J" uniqKey="Weisdorf D" first="Daniel J." last="Weisdorf">Daniel J. Weisdorf</name><affiliation wicri:level="2"><nlm:aff id="A1">Blood and Marrow Transplant Program, University of Minnesota Medical Center, Minneapolis, MN</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Minnesota</region></placeName><wicri:cityArea>Blood and Marrow Transplant Program, University of Minnesota Medical Center, Minneapolis</wicri:cityArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">23989431</idno><idno type="pmc">3951192</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3951192</idno><idno type="RBID">PMC:3951192</idno><idno type="doi">10.1038/leu.2013.253</idno><date when="2013">2013</date><idno type="wicri:Area/Pmc/Corpus">002D96</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002D96</idno><idno type="wicri:Area/Pmc/Curation">002C46</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">002C46</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Ph+ ALL patients in first complete remission have similar survival after reduced intensity and myeloablative allogeneic transplantation: Impact of tyrosine kinase inhibitor and minimal residual disease</title><author><name sortKey="Bachanova, Veronika" sort="Bachanova, Veronika" uniqKey="Bachanova V" first="Veronika" last="Bachanova">Veronika Bachanova</name><affiliation wicri:level="2"><nlm:aff id="A1">Blood and Marrow Transplant Program, University of Minnesota Medical Center, Minneapolis, MN</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Minnesota</region></placeName><wicri:cityArea>Blood and Marrow Transplant Program, University of Minnesota Medical Center, Minneapolis</wicri:cityArea></affiliation></author><author><name sortKey="Marks, David I" sort="Marks, David I" uniqKey="Marks D" first="David I." last="Marks">David I. Marks</name><affiliation wicri:level="1"><nlm:aff id="A2">Bristol Adult BMT Unit, Bristol Children’s Hospital, Bristol, UNITED KINGDOM</nlm:aff><country xml:lang="fr" wicri:curation="lc">Royaume-Uni</country><wicri:regionArea>Bristol Adult BMT Unit, Bristol Children’s Hospital, Bristol</wicri:regionArea></affiliation></author><author><name sortKey="Zhang, Mei Jie" sort="Zhang, Mei Jie" uniqKey="Zhang M" first="Mei-Jie" last="Zhang">Mei-Jie Zhang</name><affiliation wicri:level="2"><nlm:aff id="A3">Center for International Blood and Marrow Transplant Research (CIBMTR), Medical College of Wisconsin, Milwaukee, WI</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Wisconsin</region></placeName><wicri:cityArea>Center for International Blood and Marrow Transplant Research (CIBMTR), Medical College of Wisconsin, Milwaukee</wicri:cityArea></affiliation></author><author><name sortKey="Wang, Hailin" sort="Wang, Hailin" uniqKey="Wang H" first="Hailin" last="Wang">Hailin Wang</name><affiliation wicri:level="2"><nlm:aff id="A3">Center for International Blood and Marrow Transplant Research (CIBMTR), Medical College of Wisconsin, Milwaukee, WI</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Wisconsin</region></placeName><wicri:cityArea>Center for International Blood and Marrow Transplant Research (CIBMTR), Medical College of Wisconsin, Milwaukee</wicri:cityArea></affiliation></author><author><name sortKey="De Lima, Marcos" sort="De Lima, Marcos" uniqKey="De Lima M" first="Marcos" last="De Lima">Marcos De Lima</name><affiliation wicri:level="2"><nlm:aff id="A4">Seidman Cancer Center, University Hospitals Case Medical Center, Cleveland, OH</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Ohio</region></placeName><wicri:cityArea>Seidman Cancer Center, University Hospitals Case Medical Center, Cleveland</wicri:cityArea></affiliation></author><author><name sortKey="Aljurf, Mahmoud D" sort="Aljurf, Mahmoud D" uniqKey="Aljurf M" first="Mahmoud D." last="Aljurf">Mahmoud D. Aljurf</name><affiliation wicri:level="1"><nlm:aff id="A5">King Faisal Specialist Hospital and Research Center, Riyadh, SAUDI ARABIA</nlm:aff><country xml:lang="fr" wicri:curation="lc">Arabie saoudite</country><wicri:regionArea>King Faisal Specialist Hospital and Research Center, Riyadh</wicri:regionArea></affiliation></author><author><name sortKey="Arellano, Martha" sort="Arellano, Martha" uniqKey="Arellano M" first="Martha" last="Arellano">Martha Arellano</name><affiliation wicri:level="2"><nlm:aff id="A6">Winship Cancer Institute, Emory University, Atlanta, GA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Géorgie (États-Unis)</region></placeName><wicri:cityArea>Winship Cancer Institute, Emory University, Atlanta</wicri:cityArea></affiliation></author><author><name sortKey="Artz, Andrew S" sort="Artz, Andrew S" uniqKey="Artz A" first="Andrew S." last="Artz">Andrew S. Artz</name><affiliation wicri:level="2"><nlm:aff id="A7">University of Chicago Medicine, Chicago, IL</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Illinois</region></placeName><wicri:cityArea>University of Chicago Medicine, Chicago</wicri:cityArea></affiliation></author><author><name sortKey="Bacher, Ulrike" sort="Bacher, Ulrike" uniqKey="Bacher U" first="Ulrike" last="Bacher">Ulrike Bacher</name><affiliation wicri:level="1"><nlm:aff id="A8">Klinik und Poliklinik fur Stammzelltransplantation, Universitatsklinikum Hamburg-Eppendorf, Hamburg, GERMANY</nlm:aff><country xml:lang="fr" wicri:curation="lc">Allemagne</country><wicri:regionArea>Klinik und Poliklinik fur Stammzelltransplantation, Universitatsklinikum Hamburg-Eppendorf, Hamburg</wicri:regionArea></affiliation></author><author><name sortKey="Cahn, Jean Yves" sort="Cahn, Jean Yves" uniqKey="Cahn J" first="Jean-Yves" last="Cahn">Jean-Yves Cahn</name><affiliation wicri:level="1"><nlm:aff id="A9">Department of Hematology, University Hospital, Grenoble, FRANCE</nlm:aff><country xml:lang="fr" wicri:curation="lc">France</country><wicri:regionArea>Department of Hematology, University Hospital, Grenoble</wicri:regionArea></affiliation></author><author><name sortKey="Chen, Yi Bin" sort="Chen, Yi Bin" uniqKey="Chen Y" first="Yi-Bin" last="Chen">Yi-Bin Chen</name><affiliation wicri:level="2"><nlm:aff id="A10">Massachusetts General Hospital, Boston, MA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Massachusetts</region></placeName><wicri:cityArea>Massachusetts General Hospital, Boston</wicri:cityArea></affiliation></author><author><name sortKey="Copelan, Edward A" sort="Copelan, Edward A" uniqKey="Copelan E" first="Edward A." last="Copelan">Edward A. Copelan</name><affiliation wicri:level="2"><nlm:aff id="A11">Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Caroline du Nord</region></placeName><wicri:cityArea>Levine Cancer Institute, Carolinas HealthCare System, Charlotte</wicri:cityArea></affiliation></author><author><name sortKey="Drobyski, William R" sort="Drobyski, William R" uniqKey="Drobyski W" first="William R." last="Drobyski">William R. Drobyski</name><affiliation wicri:level="2"><nlm:aff id="A12">Medical College of Wisconsin, Milwaukee, WI</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Wisconsin</region></placeName><wicri:cityArea>Medical College of Wisconsin, Milwaukee</wicri:cityArea></affiliation></author><author><name sortKey="Gale, Robert Peter" sort="Gale, Robert Peter" uniqKey="Gale R" first="Robert Peter" last="Gale">Robert Peter Gale</name><affiliation wicri:level="1"><nlm:aff id="A13">Imperial College, Section of Hematology, Division of Experimental Medicine, Department of Medicine, London, UNITED KINGDOM</nlm:aff><country xml:lang="fr" wicri:curation="lc">Royaume-Uni</country><wicri:regionArea>Imperial College, Section of Hematology, Division of Experimental Medicine, Department of Medicine, London</wicri:regionArea></affiliation></author><author><name sortKey="Greer, John P" sort="Greer, John P" uniqKey="Greer J" first="John P" last="Greer">John P. Greer</name><affiliation wicri:level="2"><nlm:aff id="A14">Vanderbilt University Medical Center, Nashville, TN</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Tennessee</region></placeName><wicri:cityArea>Vanderbilt University Medical Center, Nashville</wicri:cityArea></affiliation></author><author><name sortKey="Gupta, Vikas" sort="Gupta, Vikas" uniqKey="Gupta V" first="Vikas" last="Gupta">Vikas Gupta</name><affiliation wicri:level="1"><nlm:aff id="A15">Princess Margaret Hospital, Toronto, ON, CANADA</nlm:aff><country xml:lang="fr" wicri:curation="lc">Canada</country><wicri:regionArea>Princess Margaret Hospital, Toronto, ON</wicri:regionArea></affiliation></author><author><name sortKey="Hale, Gregory A" sort="Hale, Gregory A" uniqKey="Hale G" first="Gregory A." last="Hale">Gregory A. Hale</name><affiliation wicri:level="2"><nlm:aff id="A16">All Children’s Hospital, St. Petersburg, FL</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Floride</region></placeName><wicri:cityArea>All Children’s Hospital, St. Petersburg</wicri:cityArea></affiliation></author><author><name sortKey="Kebriaei, Partow" sort="Kebriaei, Partow" uniqKey="Kebriaei P" first="Partow" last="Kebriaei">Partow Kebriaei</name><affiliation wicri:level="2"><nlm:aff id="A17">Stem Cell Transplantation and Cellular Therapy, MD Anderson Cancer Center, Houston, TX</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Stem Cell Transplantation and Cellular Therapy, MD Anderson Cancer Center, Houston</wicri:cityArea></affiliation></author><author><name sortKey="Lazarus, Hillard M" sort="Lazarus, Hillard M" uniqKey="Lazarus H" first="Hillard M." last="Lazarus">Hillard M. Lazarus</name><affiliation wicri:level="2"><nlm:aff id="A4">Seidman Cancer Center, University Hospitals Case Medical Center, Cleveland, OH</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Ohio</region></placeName><wicri:cityArea>Seidman Cancer Center, University Hospitals Case Medical Center, Cleveland</wicri:cityArea></affiliation></author><author><name sortKey="Lewis, Ian D" sort="Lewis, Ian D" uniqKey="Lewis I" first="Ian D." last="Lewis">Ian D. Lewis</name><affiliation wicri:level="1"><nlm:aff id="A18">Haematology and Bone Marrow Transplant Unit, Royal Adelaide Hospital/SA Pathology, Adelaide, AUSTRALIA</nlm:aff><country xml:lang="fr" wicri:curation="lc">Australie</country><wicri:regionArea>Haematology and Bone Marrow Transplant Unit, Royal Adelaide Hospital/SA Pathology, Adelaide</wicri:regionArea></affiliation></author><author><name sortKey="Lewis, Victor A" sort="Lewis, Victor A" uniqKey="Lewis V" first="Victor A." last="Lewis">Victor A. Lewis</name><affiliation wicri:level="1"><nlm:aff id="A19">Alberta Children’s Hospital, Calgary, AB, CANADA</nlm:aff><country xml:lang="fr" wicri:curation="lc">Canada</country><wicri:regionArea>Alberta Children’s Hospital, Calgary, AB</wicri:regionArea></affiliation></author><author><name sortKey="Liesveld, Jane L" sort="Liesveld, Jane L" uniqKey="Liesveld J" first="Jane L." last="Liesveld">Jane L. Liesveld</name><affiliation wicri:level="2"><nlm:aff id="A20">Strong Memorial Hospital, University of Rochester Medical Center; Rochester, NY</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">État de New York</region></placeName><wicri:cityArea>Strong Memorial Hospital, University of Rochester Medical Center; Rochester</wicri:cityArea></affiliation></author><author><name sortKey="Litzow, Mark R" sort="Litzow, Mark R" uniqKey="Litzow M" first="Mark R." last="Litzow">Mark R. Litzow</name><affiliation wicri:level="2"><nlm:aff id="A21">Hematology and Internal Medicine, Mayo Clinic Rochester, Rochester, MN</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Minnesota</region></placeName><wicri:cityArea>Hematology and Internal Medicine, Mayo Clinic Rochester, Rochester</wicri:cityArea></affiliation></author><author><name sortKey="Loren, Alison W" sort="Loren, Alison W" uniqKey="Loren A" first="Alison W." last="Loren">Alison W. Loren</name><affiliation wicri:level="2"><nlm:aff id="A22">Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>Perelman School of Medicine at the University of Pennsylvania, Philadelphia</wicri:cityArea></affiliation></author><author><name sortKey="Miller, Alan M" sort="Miller, Alan M" uniqKey="Miller A" first="Alan M." last="Miller">Alan M. Miller</name><affiliation wicri:level="2"><nlm:aff id="A23">Baylor University Medical Center, Dallas, TX</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Baylor University Medical Center, Dallas</wicri:cityArea></affiliation></author><author><name sortKey="Norkin, Maxim" sort="Norkin, Maxim" uniqKey="Norkin M" first="Maxim" last="Norkin">Maxim Norkin</name><affiliation wicri:level="2"><nlm:aff id="A24">Shands HealthCare and University of Florida, Gainesville, FL</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Floride</region></placeName><wicri:cityArea>Shands HealthCare and University of Florida, Gainesville</wicri:cityArea></affiliation></author><author><name sortKey="Oran, Betul" sort="Oran, Betul" uniqKey="Oran B" first="Betul" last="Oran">Betul Oran</name><affiliation wicri:level="2"><nlm:aff id="A17">Stem Cell Transplantation and Cellular Therapy, MD Anderson Cancer Center, Houston, TX</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Stem Cell Transplantation and Cellular Therapy, MD Anderson Cancer Center, Houston</wicri:cityArea></affiliation></author><author><name sortKey="Pidala, Joseph" sort="Pidala, Joseph" uniqKey="Pidala J" first="Joseph" last="Pidala">Joseph Pidala</name><affiliation wicri:level="2"><nlm:aff id="A25">Blood and Marrow Transplantation, Moffitt Cancer Center, Tampa, FL</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Floride</region></placeName><wicri:cityArea>Blood and Marrow Transplantation, Moffitt Cancer Center, Tampa</wicri:cityArea></affiliation></author><author><name sortKey="Rowe, Jacob M" sort="Rowe, Jacob M" uniqKey="Rowe J" first="Jacob M." last="Rowe">Jacob M. Rowe</name><affiliation wicri:level="1"><nlm:aff id="A26">Department of Hematology, Rambam Medical Center, Haifa, ISRAEL</nlm:aff><country xml:lang="fr" wicri:curation="lc">Israël</country><wicri:regionArea>Department of Hematology, Rambam Medical Center, Haifa</wicri:regionArea></affiliation></author><author><name sortKey="Savani, Bipin N" sort="Savani, Bipin N" uniqKey="Savani B" first="Bipin N." last="Savani">Bipin N. Savani</name><affiliation wicri:level="2"><nlm:aff id="A14">Vanderbilt University Medical Center, Nashville, TN</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Tennessee</region></placeName><wicri:cityArea>Vanderbilt University Medical Center, Nashville</wicri:cityArea></affiliation></author><author><name sortKey="Saber, Wael" sort="Saber, Wael" uniqKey="Saber W" first="Wael" last="Saber">Wael Saber</name><affiliation wicri:level="2"><nlm:aff id="A3">Center for International Blood and Marrow Transplant Research (CIBMTR), Medical College of Wisconsin, Milwaukee, WI</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Wisconsin</region></placeName><wicri:cityArea>Center for International Blood and Marrow Transplant Research (CIBMTR), Medical College of Wisconsin, Milwaukee</wicri:cityArea></affiliation></author><author><name sortKey="Vij, Ravi" sort="Vij, Ravi" uniqKey="Vij R" first="Ravi" last="Vij">Ravi Vij</name><affiliation wicri:level="2"><nlm:aff id="A27">Barnes Jewish Hospital, Washington University School of Medicine, St. Louis, MO</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Missouri (État)</region></placeName><wicri:cityArea>Barnes Jewish Hospital, Washington University School of Medicine, St. Louis</wicri:cityArea></affiliation></author><author><name sortKey="Waller, Edmund K" sort="Waller, Edmund K" uniqKey="Waller E" first="Edmund K." last="Waller">Edmund K. Waller</name><affiliation wicri:level="2"><nlm:aff id="A28">Bone Marrow and Stem Cell Transplant Center, Emory University Hospital, Atlanta, GA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Géorgie (États-Unis)</region></placeName><wicri:cityArea>Bone Marrow and Stem Cell Transplant Center, Emory University Hospital, Atlanta</wicri:cityArea></affiliation></author><author><name sortKey="Wiernik, Peter H" sort="Wiernik, Peter H" uniqKey="Wiernik P" first="Peter H." last="Wiernik">Peter H. Wiernik</name><affiliation wicri:level="2"><nlm:aff id="A29">Our Lady of Mercy Medical Center, Bronx, NY</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">État de New York</region></placeName><wicri:cityArea>Our Lady of Mercy Medical Center, Bronx</wicri:cityArea></affiliation></author><author><name sortKey="Weisdorf, Daniel J" sort="Weisdorf, Daniel J" uniqKey="Weisdorf D" first="Daniel J." last="Weisdorf">Daniel J. Weisdorf</name><affiliation wicri:level="2"><nlm:aff id="A1">Blood and Marrow Transplant Program, University of Minnesota Medical Center, Minneapolis, MN</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Minnesota</region></placeName><wicri:cityArea>Blood and Marrow Transplant Program, University of Minnesota Medical Center, Minneapolis</wicri:cityArea></affiliation></author></analytic><series><title level="j">Leukemia</title><idno type="ISSN">0887-6924</idno><idno type="eISSN">1476-5551</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p id="P1">The efficacy of reduced intensity conditioning (RIC) allogeneic hematopoietic cell transplantation (HCT) for Ph+ acute lymphoblastic leukemia (ALL) is uncertain. We analyzed 197 adults with Ph+ ALL in first complete remission; 67 patients receiving RIC were matched with 130 receiving myeloablative conditioning (MAC) for age, donor type, and HCT year. Over 75% received pre-HCT tyrosine kinase inhibitors (TKI), mostly imatinib; 39% (RIC) and 49% (MAC) were MRD<sup>neg</sup> pre-HCT. At a median 4.5 years follow-up, 1-year transplant-related mortality (TRM) was lower in RIC (13%) than MAC (36%;p=0.001) while the 3-year relapse rate was 49% in RIC and 28% in MAC (p=0.058). Overall survival was similar (RIC 39% [95% CI:27–52] vs. 35% [95% CI:270–44];p=0.62). Patients MRD<sup>pos</sup> pre-HCT had higher risk of relapse with RIC versus MAC (HR 1.97;p=0.026). However, patients receiving pre-HCT TKI in combination with MRD negativity pre-RIC HCT had superior OS (55%) compared to a similar MRD<sup>neg</sup> population after MAC (33%; p=0.0042). In multivariate analysis, RIC lowered TRM (HR 0.6; p=0.057), but absence of pre-HCT TKI (HR 1.88;p=0.018), RIC (HR 1.891;p=0.054) and pre-HCT MRD<sup>pos</sup> (HR 1.6; p=0.070) increased relapse risk. RIC is a valid alternative strategy for Ph+ ALL patients ineligible for MAC and MRD<sup>neg</sup> status is preferred pre-HCT.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Moorman, Av" uniqKey="Moorman A">AV Moorman</name></author><author><name sortKey="Harrison, Cj" uniqKey="Harrison C">CJ Harrison</name></author><author><name sortKey="Buck, Ga" uniqKey="Buck G">GA Buck</name></author><author><name sortKey="Richards, Sm" uniqKey="Richards S">SM Richards</name></author><author><name sortKey="Secker Walker, Lm" uniqKey="Secker Walker L">LM Secker-Walker</name></author><author><name sortKey="Martineau, M" uniqKey="Martineau M">M Martineau</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mizuta, S" uniqKey="Mizuta S">S Mizuta</name></author><author><name sortKey="Matsuo, K" uniqKey="Matsuo K">K Matsuo</name></author><author><name sortKey="Yagasaki, F" uniqKey="Yagasaki F">F 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<front><journal-meta><journal-id journal-id-type="nlm-journal-id">8704895</journal-id><journal-id journal-id-type="pubmed-jr-id">5536</journal-id><journal-id journal-id-type="nlm-ta">Leukemia</journal-id><journal-id journal-id-type="iso-abbrev">Leukemia</journal-id><journal-title-group><journal-title>Leukemia</journal-title></journal-title-group><issn pub-type="ppub">0887-6924</issn><issn pub-type="epub">1476-5551</issn></journal-meta><article-meta><article-id pub-id-type="pmid">23989431</article-id><article-id pub-id-type="pmc">3951192</article-id><article-id pub-id-type="doi">10.1038/leu.2013.253</article-id><article-id pub-id-type="manuscript">NIHMS549962</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Ph+ ALL patients in first complete remission have similar survival after reduced intensity and myeloablative allogeneic transplantation: Impact of tyrosine kinase inhibitor 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contrib-type="author"><name><surname>Hale</surname><given-names>Gregory A.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A16">16</xref></contrib><contrib contrib-type="author"><name><surname>Kebriaei</surname><given-names>Partow</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A17">17</xref></contrib><contrib contrib-type="author"><name><surname>Lazarus</surname><given-names>Hillard M.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A4">4</xref></contrib><contrib contrib-type="author"><name><surname>Lewis</surname><given-names>Ian D.</given-names></name><degrees>MBBS, PhD</degrees><xref ref-type="aff" rid="A18">18</xref></contrib><contrib contrib-type="author"><name><surname>Lewis</surname><given-names>Victor A.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A19">19</xref></contrib><contrib contrib-type="author"><name><surname>Liesveld</surname><given-names>Jane L.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A20">20</xref></contrib><contrib contrib-type="author"><name><surname>Litzow</surname><given-names>Mark R.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A21">21</xref></contrib><contrib contrib-type="author"><name><surname>Loren</surname><given-names>Alison W.</given-names></name><degrees>MD, MS</degrees><xref ref-type="aff" rid="A22">22</xref></contrib><contrib contrib-type="author"><name><surname>Miller</surname><given-names>Alan M.</given-names></name><degrees>MD, PhD</degrees><xref ref-type="aff" rid="A23">23</xref></contrib><contrib contrib-type="author"><name><surname>Norkin</surname><given-names>Maxim</given-names></name><degrees>MD, PhD</degrees><xref ref-type="aff" rid="A24">24</xref></contrib><contrib contrib-type="author"><name><surname>Oran</surname><given-names>Betul</given-names></name><degrees>MD, MS</degrees><xref ref-type="aff" rid="A17">17</xref></contrib><contrib contrib-type="author"><name><surname>Pidala</surname><given-names>Joseph</given-names></name><degrees>MD, MS</degrees><xref ref-type="aff" rid="A25">25</xref></contrib><contrib contrib-type="author"><name><surname>Rowe</surname><given-names>Jacob M.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A26">26</xref></contrib><contrib contrib-type="author"><name><surname>Savani</surname><given-names>Bipin N.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A14">14</xref></contrib><contrib contrib-type="author"><name><surname>Saber</surname><given-names>Wael</given-names></name><degrees>MD, MS</degrees><xref ref-type="aff" rid="A3">3</xref></contrib><contrib contrib-type="author"><name><surname>Vij</surname><given-names>Ravi</given-names></name><degrees>MBBS</degrees><xref ref-type="aff" rid="A27">27</xref></contrib><contrib contrib-type="author"><name><surname>Waller</surname><given-names>Edmund K.</given-names></name><degrees>MD, PhD</degrees><xref ref-type="aff" rid="A28">28</xref></contrib><contrib contrib-type="author"><name><surname>Wiernik</surname><given-names>Peter H.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A29">29</xref></contrib><contrib contrib-type="author"><name><surname>Weisdorf</surname><given-names>Daniel J.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A1">1</xref></contrib></contrib-group><aff id="A1"><label>1</label>Blood and Marrow Transplant Program, University of Minnesota Medical Center, Minneapolis, MN</aff><aff id="A2"><label>2</label>Bristol Adult BMT Unit, Bristol Children’s Hospital, Bristol, UNITED KINGDOM</aff><aff id="A3"><label>3</label>Center for International Blood and Marrow Transplant Research (CIBMTR), Medical College of Wisconsin, Milwaukee, WI</aff><aff id="A4"><label>4</label>Seidman Cancer Center, University Hospitals Case Medical Center, Cleveland, OH</aff><aff id="A5"><label>5</label>King Faisal Specialist Hospital and Research Center, Riyadh, SAUDI ARABIA</aff><aff id="A6"><label>6</label>Winship Cancer Institute, Emory University, Atlanta, GA</aff><aff id="A7"><label>7</label>University of Chicago Medicine, Chicago, IL</aff><aff id="A8"><label>8</label>Klinik und Poliklinik fur Stammzelltransplantation, Universitatsklinikum Hamburg-Eppendorf, Hamburg, GERMANY</aff><aff id="A9"><label>9</label>Department of Hematology, University Hospital, Grenoble, FRANCE</aff><aff id="A10"><label>10</label>Massachusetts General Hospital, Boston, MA</aff><aff id="A11"><label>11</label>Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC</aff><aff id="A12"><label>12</label>Medical College of Wisconsin, Milwaukee, WI</aff><aff id="A13"><label>13</label>Imperial College, Section of Hematology, Division of Experimental Medicine, Department of Medicine, London, UNITED KINGDOM</aff><aff id="A14"><label>14</label>Vanderbilt University Medical Center, Nashville, TN</aff><aff id="A15"><label>15</label>Princess Margaret Hospital, Toronto, ON, CANADA</aff><aff id="A16"><label>16</label>All Children’s Hospital, St. Petersburg, FL</aff><aff id="A17"><label>17</label>Stem Cell Transplantation and Cellular Therapy, MD Anderson Cancer Center, Houston, TX</aff><aff id="A18"><label>18</label>Haematology and Bone Marrow Transplant Unit, Royal Adelaide Hospital/SA Pathology, Adelaide, AUSTRALIA</aff><aff id="A19"><label>19</label>Alberta Children’s Hospital, Calgary, AB, CANADA</aff><aff id="A20"><label>20</label>Strong Memorial Hospital, University of Rochester Medical Center; Rochester, NY</aff><aff id="A21"><label>21</label>Hematology and Internal Medicine, Mayo Clinic Rochester, Rochester, MN</aff><aff id="A22"><label>22</label>Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA</aff><aff id="A23"><label>23</label>Baylor University Medical Center, Dallas, TX</aff><aff id="A24"><label>24</label>Shands HealthCare and University of Florida, Gainesville, FL</aff><aff id="A25"><label>25</label>Blood and Marrow Transplantation, Moffitt Cancer Center, Tampa, FL</aff><aff id="A26"><label>26</label>Department of Hematology, Rambam Medical Center, Haifa, ISRAEL</aff><aff id="A27"><label>27</label>Barnes Jewish Hospital, Washington University School of Medicine, St. Louis, MO</aff><aff id="A28"><label>28</label>Bone Marrow and Stem Cell Transplant Center, Emory University Hospital, Atlanta, GA</aff><aff id="A29"><label>29</label>Our Lady of Mercy Medical Center, Bronx, NY</aff><author-notes><corresp id="cor1"><bold>Address for Correspondence:</bold> Veronika Bachanova, MD, PhD, Blood and Marrow Transplant Program, University of Minnesota, Mayo Mail Code 480; 420 Delaware Street SE, Minneapolis, MN 55455, <email>bach0173@umn.edu</email>, Phone: 612-624-5620; Fax: 612-625-6919</corresp></author-notes><pub-date pub-type="nihms-submitted"><day>7</day><month>2</month><year>2014</year></pub-date><pub-date pub-type="epub"><day>30</day><month>8</month><year>2013</year></pub-date><pub-date pub-type="ppub"><month>3</month><year>2014</year></pub-date><pub-date pub-type="pmc-release"><day>01</day><month>9</month><year>2014</year></pub-date><volume>28</volume><issue>3</issue><fpage>658</fpage><lpage>665</lpage><pmc-comment>elocation-id from pubmed: 10.1038/leu.2013.253</pmc-comment>
<permissions><license><license-p>Users may view, print, copy, download and text and data- mine the content in such documents, for the purposes of academic research, subject always to the full Conditions of use: <uri xlink:type="simple" xlink:href="http://www.nature.com/authors/editorial_policies/license.html#terms">http://www.nature.com/authors/editorial_policies/license.html#terms</uri></license-p></license></permissions><abstract><p id="P1">The efficacy of reduced intensity conditioning (RIC) allogeneic hematopoietic cell transplantation (HCT) for Ph+ acute lymphoblastic leukemia (ALL) is uncertain. We analyzed 197 adults with Ph+ ALL in first complete remission; 67 patients receiving RIC were matched with 130 receiving myeloablative conditioning (MAC) for age, donor type, and HCT year. Over 75% received pre-HCT tyrosine kinase inhibitors (TKI), mostly imatinib; 39% (RIC) and 49% (MAC) were MRD<sup>neg</sup> pre-HCT. At a median 4.5 years follow-up, 1-year transplant-related mortality (TRM) was lower in RIC (13%) than MAC (36%;p=0.001) while the 3-year relapse rate was 49% in RIC and 28% in MAC (p=0.058). Overall survival was similar (RIC 39% [95% CI:27–52] vs. 35% [95% CI:270–44];p=0.62). Patients MRD<sup>pos</sup> pre-HCT had higher risk of relapse with RIC versus MAC (HR 1.97;p=0.026). However, patients receiving pre-HCT TKI in combination with MRD negativity pre-RIC HCT had superior OS (55%) compared to a similar MRD<sup>neg</sup> population after MAC (33%; p=0.0042). In multivariate analysis, RIC lowered TRM (HR 0.6; p=0.057), but absence of pre-HCT TKI (HR 1.88;p=0.018), RIC (HR 1.891;p=0.054) and pre-HCT MRD<sup>pos</sup> (HR 1.6; p=0.070) increased relapse risk. RIC is a valid alternative strategy for Ph+ ALL patients ineligible for MAC and MRD<sup>neg</sup> status is preferred pre-HCT.</p></abstract><kwd-group><kwd>Acute lymphoblastic leukemia</kwd><kwd>Philadelphia chromosome</kwd><kwd>reduced intensity conditioning</kwd><kwd>allograft</kwd><kwd>minimal residual disease</kwd><kwd>tyrosine-kinase inhibitor</kwd></kwd-group></article-meta></front><floats-group><fig id="F1" orientation="portrait" position="float"><label>Figure 1</label><caption><p id="P34"><bold>(A)</bold> Kaplan-Meier estimate of overall survival using reduced intensity or myeloablative conditioning HCT for Ph+ ALL by MRD status</p><p id="P35"><bold>(B)</bold> Cumulative incidence of relapse by pre HCT MRD and conditioning intensity</p><p id="P36"><bold>(C)</bold> Cumulative incidence of treatment related mortality</p></caption><graphic xlink:href="nihms549962f1a"></graphic><graphic xlink:href="nihms549962f1b"></graphic><graphic xlink:href="nihms549962f1c"></graphic></fig><table-wrap id="T1" position="float" orientation="portrait"><label>Table 1</label><caption><p id="P37">Characteristics of adults with Ph+ ALL who received reduced intensity conditioning (RIC) allogeneic donor HCT in CR1 between 2000–2009 and a matched cohort receiving myeloablative (MAC) allogeneic HCT</p></caption><table frame="below" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Variable</th><th align="right" rowspan="1" colspan="1">RIC</th><th align="right" rowspan="1" colspan="1">MAC</th><th align="center" rowspan="1" colspan="1">P-value</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">Number of patients</td><td align="right" rowspan="1" colspan="1">67</td><td align="right" rowspan="1" colspan="1">130</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1">Number of centers</td><td align="right" rowspan="1" colspan="1">30</td><td align="right" rowspan="1" colspan="1">66</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1">Age, median (range)</td><td align="right" rowspan="1" colspan="1">54 (19–69)</td><td align="right" rowspan="1" colspan="1">50 (19–66)</td><td align="center" rowspan="1" colspan="1">0.02</td></tr><tr><td align="left" rowspan="1" colspan="1">Sex</td><td align="right" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1">0.94</td></tr><tr><td align="left" rowspan="1" colspan="1"> Male</td><td align="right" rowspan="1" colspan="1">37 (55)</td><td align="right" rowspan="1" colspan="1">71 (55)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> Female</td><td align="right" rowspan="1" colspan="1">30 (45)</td><td align="right" rowspan="1" colspan="1">59 (45)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1">Karnofsky score</td><td align="right" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1">0.36</td></tr><tr><td align="left" rowspan="1" colspan="1"> < 80%</td><td align="right" rowspan="1" colspan="1">8 (12)</td><td align="right" rowspan="1" colspan="1">8 (6)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> 80 – 100%</td><td align="right" rowspan="1" colspan="1">54 (81)</td><td align="right" rowspan="1" colspan="1">113 (87)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> Missing</td><td align="right" rowspan="1" colspan="1">5 (7)</td><td align="right" rowspan="1" colspan="1">9 (7)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1">HCT Comorbidity Index</td><td align="right" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1">0.03</td></tr><tr><td align="left" rowspan="1" colspan="1"> 0</td><td align="right" rowspan="1" colspan="1">54 (81)</td><td align="right" rowspan="1" colspan="1">119 (92)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> ≥1</td><td align="right" rowspan="1" colspan="1">13 (19)</td><td align="right" rowspan="1" colspan="1">11 (8)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1">Fungal infection prior to HCT</td><td align="right" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1">0.006</td></tr><tr><td align="left" rowspan="1" colspan="1"> No</td><td align="right" rowspan="1" colspan="1">57 (85)</td><td align="right" rowspan="1" colspan="1">126 (97)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> Yes</td><td align="right" rowspan="1" colspan="1">8 (12)</td><td align="right" rowspan="1" colspan="1">4 (3)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> Missing</td><td align="right" rowspan="1" colspan="1">2 (3)</td><td align="right" rowspan="1" colspan="1">0</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1">WBC at diagnosis, ×10^9/L</td><td align="right" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1">0.23</td></tr><tr><td align="left" rowspan="1" colspan="1"> < 30</td><td align="right" rowspan="1" colspan="1">41 (61)</td><td align="right" rowspan="1" colspan="1">70 (54)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> 30 – 100</td><td align="right" rowspan="1" colspan="1">14 (21)</td><td align="right" rowspan="1" colspan="1">23 (18)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> > 100</td><td align="right" rowspan="1" colspan="1">5 (7)</td><td align="right" rowspan="1" colspan="1">24 (18)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> Missing</td><td align="right" rowspan="1" colspan="1">7 (10)</td><td align="right" rowspan="1" colspan="1">13 (10)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1">Cytogenetic abnormalities</td><td align="right" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1">0.34</td></tr><tr><td align="left" rowspan="1" colspan="1"> t(9:22) only</td><td align="right" rowspan="1" colspan="1">32 (48)</td><td align="right" rowspan="1" colspan="1">48 (37)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> t(9:22) and other</td><td align="right" rowspan="1" colspan="1">25 (37)</td><td align="right" rowspan="1" colspan="1">58 (45)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> Other</td><td align="right" rowspan="1" colspan="1">4 (6)</td><td align="right" rowspan="1" colspan="1">5 (4)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> Missing</td><td align="right" rowspan="1" colspan="1">6 (9)</td><td align="right" rowspan="1" colspan="1">19 (15)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1">Time from diagnosis to 1<sup>st</sup> complete remission</td><td align="right" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1">0.76</td></tr><tr><td align="left" rowspan="1" colspan="1"> Median (interquartile range) in days</td><td align="right" rowspan="1" colspan="1">42 (34–82)</td><td align="right" rowspan="1" colspan="1">52 (31–111)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> Missing</td><td align="right" rowspan="1" colspan="1">1 (1)</td><td align="right" rowspan="1" colspan="1">7 (5)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1">Time from diagnosis to transplant</td><td align="right" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1">0.02</td></tr><tr><td align="left" rowspan="1" colspan="1"> ≤ 5 months</td><td align="right" rowspan="1" colspan="1">20 (30)</td><td align="right" rowspan="1" colspan="1">64 (49)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> > 5 months</td><td align="right" rowspan="1" colspan="1">46 (69)</td><td align="right" rowspan="1" colspan="1">66 (51)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> Missing</td><td align="right" rowspan="1" colspan="1">1 (1)</td><td align="right" rowspan="1" colspan="1">0</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1">Minimal residual disease pre-HCT</td><td align="right" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> FISH tested</td><td align="right" rowspan="1" colspan="1">59 (88)</td><td align="right" rowspan="1" colspan="1">113 (87)</td><td align="center" rowspan="1" colspan="1">0.75</td></tr><tr><td align="left" rowspan="1" colspan="1"> FISH neg/tested for MRD</td><td align="right" rowspan="1" colspan="1">36/59 (54)</td><td align="right" rowspan="1" colspan="1">63/113 (48)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> FISH pos/tested for MRD</td><td align="right" rowspan="1" colspan="1">23/59 (34)</td><td align="right" rowspan="1" colspan="1">50/113 (38)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> FISH not performed or unknown</td><td align="right" rowspan="1" colspan="1">8 (12)</td><td align="right" rowspan="1" colspan="1">17 (13)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> BCR/ABL PCR tested</td><td align="right" rowspan="1" colspan="1">42 (63)</td><td align="right" rowspan="1" colspan="1">82 (63)</td><td align="center" rowspan="1" colspan="1">0.73</td></tr><tr><td align="left" rowspan="1" colspan="1"> PCR neg/tested for MRD</td><td align="right" rowspan="1" colspan="1">21/42 (50)</td><td align="right" rowspan="1" colspan="1">46/82 (35)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> PCR pos/tested for MRD</td><td align="right" rowspan="1" colspan="1">21/42 (50)</td><td align="right" rowspan="1" colspan="1">36/82 (28)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> PCR not performed or unknown</td><td align="right" rowspan="1" colspan="1">24 (36)</td><td align="right" rowspan="1" colspan="1">48 (37)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> MRD<sup>neg</sup><xref ref-type="table-fn" rid="TFN2">**</xref></td><td align="right" rowspan="1" colspan="1">26 (39)</td><td align="right" rowspan="1" colspan="1">58 (49)</td><td align="center" rowspan="1" colspan="1">0.79</td></tr><tr><td align="left" rowspan="1" colspan="1"> MRD<sup>pos</sup><xref ref-type="table-fn" rid="TFN1">*</xref></td><td align="right" rowspan="1" colspan="1">39 (58)</td><td align="right" rowspan="1" colspan="1">62 (47)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1">TKI use prior to HCT</td><td align="right" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1">0.71</td></tr><tr><td align="left" rowspan="1" colspan="1"> No</td><td align="right" rowspan="1" colspan="1">16 (24)</td><td align="right" rowspan="1" colspan="1">28 (22)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> Yes</td><td align="right" rowspan="1" colspan="1">51 (76)</td><td align="right" rowspan="1" colspan="1">102 (78)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1">Duration of TKI pre HCT, months</td><td align="right" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1">0.41</td></tr><tr><td align="left" rowspan="1" colspan="1"> Median (range)</td><td align="right" rowspan="1" colspan="1">7 (1–12)</td><td align="right" rowspan="1" colspan="1">6 (1–54)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> <6 month</td><td align="right" rowspan="1" colspan="1">28 (42)</td><td align="right" rowspan="1" colspan="1">66 (51)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> ≥6 month</td><td align="right" rowspan="1" colspan="1">15 (22)</td><td align="right" rowspan="1" colspan="1">18 (14)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> TKI not given or unknown</td><td align="right" rowspan="1" colspan="1">24 (36)</td><td align="right" rowspan="1" colspan="1">48 (36)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1">Conditioning regimen</td><td align="right" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1">N/A</td></tr><tr><td align="left" rowspan="1" colspan="1"> MAC</td><td align="right" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> TBI>500 cGy single dose or > 800cGy</td><td align="right" rowspan="1" colspan="1">0</td><td align="right" rowspan="1" colspan="1">108 (83)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> Busulfan > 9 mg/kg + other</td><td align="right" rowspan="1" colspan="1">0</td><td align="right" rowspan="1" colspan="1">22 (17)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> RIC (includes non-myeloablative)</td><td align="right" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> Melphalan ≤ 150 mg/m<sup>2</sup></td><td align="right" rowspan="1" colspan="1">24 (36)</td><td align="right" rowspan="1" colspan="1">0</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> Busulfan ≤ 9 mg/kg</td><td align="right" rowspan="1" colspan="1">20 (30)</td><td align="right" rowspan="1" colspan="1">0</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> TBI ≤ 200 cGy dose<xref ref-type="table-fn" rid="TFN3">#</xref></td><td align="right" rowspan="1" colspan="1">18 (26)</td><td align="right" rowspan="1" colspan="1">0</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> Fludarabine + other</td><td align="right" rowspan="1" colspan="1">5 (7)</td><td align="right" rowspan="1" colspan="1">0</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1">Total body irradiation</td><td align="right" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1">N/A</td></tr><tr><td align="left" rowspan="1" colspan="1"> No</td><td align="right" rowspan="1" colspan="1">45 (67)</td><td align="right" rowspan="1" colspan="1">22 (17)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> Yes</td><td align="right" rowspan="1" colspan="1">21 (31)</td><td align="right" rowspan="1" colspan="1">108 (83)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> Missing</td><td align="right" rowspan="1" colspan="1">1 (1)</td><td align="right" rowspan="1" colspan="1">0</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1">Type of donor</td><td align="right" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1">0.10</td></tr><tr><td align="left" rowspan="1" colspan="1"> HLA - identical sibling</td><td align="right" rowspan="1" colspan="1">26 (39)</td><td align="right" rowspan="1" colspan="1">50 (38)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> Well - matched URD</td><td align="right" rowspan="1" colspan="1">28 (42)</td><td align="right" rowspan="1" colspan="1">54 (42)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> Partially – matched/ mismatched URD</td><td align="right" rowspan="1" colspan="1">5 (7)</td><td align="right" rowspan="1" colspan="1">21 (16)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> URD (matching unknown)</td><td align="right" rowspan="1" colspan="1">8 (12)</td><td align="right" rowspan="1" colspan="1">5 (4)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1">Donor –Recipient sex match</td><td align="right" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1">0.79</td></tr><tr><td align="left" rowspan="1" colspan="1"> Male-Male</td><td align="right" rowspan="1" colspan="1">22 (33)</td><td align="right" rowspan="1" colspan="1">47 (36)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> Male-Female</td><td align="right" rowspan="1" colspan="1">18 (27)</td><td align="right" rowspan="1" colspan="1">40 (31)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> Female-Male</td><td align="right" rowspan="1" colspan="1">15 (22)</td><td align="right" rowspan="1" colspan="1">24 (18)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> Female-Female</td><td align="right" rowspan="1" colspan="1">12 (18)</td><td align="right" rowspan="1" colspan="1">18 (14)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> Missing</td><td align="right" rowspan="1" colspan="1">0</td><td align="right" rowspan="1" colspan="1">1 (<1)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1">Donor-Recipient CMV match</td><td align="right" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1">0.55</td></tr><tr><td align="left" rowspan="1" colspan="1"> Donor positive/Recipient positive</td><td align="right" rowspan="1" colspan="1">27 (40)</td><td align="right" rowspan="1" colspan="1">39 (30)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> Donor positive/Recipient negative</td><td align="right" rowspan="1" colspan="1">9 (13)</td><td align="right" rowspan="1" colspan="1">15 (12)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> Donor negative/Recipient positive</td><td align="right" rowspan="1" colspan="1">14 (21)</td><td align="right" rowspan="1" colspan="1">35 (27)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> Donor negative/Recipient negative</td><td align="right" rowspan="1" colspan="1">15 (22)</td><td align="right" rowspan="1" colspan="1">38 (29)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> Missing</td><td align="right" rowspan="1" colspan="1">2 (3)</td><td align="right" rowspan="1" colspan="1">3 (2)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1">Graft type</td><td align="right" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1">0.12</td></tr><tr><td align="left" rowspan="1" colspan="1"> Bone marrow</td><td align="right" rowspan="1" colspan="1">15 (22)</td><td align="right" rowspan="1" colspan="1">43 (33)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> Peripheral blood</td><td align="right" rowspan="1" colspan="1">52 (78)</td><td align="right" rowspan="1" colspan="1">87 (67)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1">Year of transplant</td><td align="right" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1">0.53</td></tr><tr><td align="left" rowspan="1" colspan="1"> 2001–2004</td><td align="right" rowspan="1" colspan="1">40 (59)</td><td align="right" rowspan="1" colspan="1">70 (54)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> 2005–2009</td><td align="right" rowspan="1" colspan="1">27 (41)</td><td align="right" rowspan="1" colspan="1">60 (46)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1">GVHD prophylaxis</td><td align="right" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1">0.36</td></tr><tr><td align="left" rowspan="1" colspan="1"> Tacrolimus ± other</td><td align="right" rowspan="1" colspan="1">61 (46)</td><td align="right" rowspan="1" colspan="1">72 (58)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> Cyclosporine ± other</td><td align="right" rowspan="1" colspan="1">30 (45)</td><td align="right" rowspan="1" colspan="1">47 (36)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> ATG/alemtuzumab</td><td align="right" rowspan="1" colspan="1">25 (37)</td><td align="right" rowspan="1" colspan="1">23 (17)</td><td align="center" rowspan="1" colspan="1">0.032</td></tr><tr><td align="left" rowspan="1" colspan="1"> Other</td><td align="right" rowspan="1" colspan="1">6 (8)</td><td align="right" rowspan="1" colspan="1">9 (7)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1">Median follow-up of survivors: months (range)</td><td align="right" rowspan="1" colspan="1">49 (3–108)</td><td align="right" rowspan="1" colspan="1">61 (3–119)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"><bold>Post-transplant therapy</bold></td><td align="right" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1">Any TKI given as maintenance post-HCT</td><td align="right" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1">0.02</td></tr><tr><td align="left" rowspan="1" colspan="1"> No</td><td align="right" rowspan="1" colspan="1">46 (69)</td><td align="right" rowspan="1" colspan="1">108 (83)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> Yes</td><td align="right" rowspan="1" colspan="1">21 (31)</td><td align="right" rowspan="1" colspan="1">22 (17)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1">Duration of TKI given for maintenance post-HCT</td><td align="right" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1">0.05</td></tr><tr><td align="left" rowspan="1" colspan="1"> < 3 months</td><td align="right" rowspan="1" colspan="1">7 (10)</td><td align="right" rowspan="1" colspan="1">4 (3)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> 3–12 months</td><td align="right" rowspan="1" colspan="1">9 (13)</td><td align="right" rowspan="1" colspan="1">9 (7)</td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> ≤ 12 months</td><td align="right" rowspan="1" colspan="1">4 (6)</td><td align="right" rowspan="1" colspan="1">9 (7)</td><td align="center" rowspan="1" colspan="1"></td></tr></tbody></table><table-wrap-foot><fn id="TFN1"><label>*</label><p id="P38">Includes both FISH and/or BCR/ABL PCR positive,</p></fn><fn id="TFN2"><label>**</label><p id="P39">Includes FISH negative and BCR/ABL PCR negative or missing,</p></fn><fn id="TFN3"><label>#</label><p id="P40">one patient received TBI <500 cGy single dose</p></fn><fn id="TFN4" fn-type="abbr"><p id="P41">Abbreviations: ALL acute lymphoblastic leukemia, RIC reduced intensity conditioning, MAC myeloablative conditioning, HCT hematopoietic cell transplantation, MRD minimal residual disease, TKI tyrosine kinase inhibitor, CMV cytomegalovirus, TBI total body irradiation, GVHD graft versus host disease,</p></fn></table-wrap-foot></table-wrap><table-wrap id="T2" position="float" orientation="landscape"><label>Table 2</label><caption><p id="P42">Outcomes after HCT: Univariate analysis</p></caption><table frame="below" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1"></th><th colspan="2" align="center" valign="bottom" rowspan="1">RIC</th><th colspan="2" align="center" valign="bottom" rowspan="1">MAC</th><th align="center" rowspan="1" colspan="1">P-value</th></tr><tr><th align="left" rowspan="1" colspan="1"></th><th align="center" rowspan="1" colspan="1">N Eval</th><th align="center" rowspan="1" colspan="1">Prob (95% CI)</th><th align="center" rowspan="1" colspan="1">N Eval</th><th align="center" rowspan="1" colspan="1">Prob (95% CI)</th><th align="center" rowspan="1" colspan="1"></th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">Relapse</td><td align="center" rowspan="1" colspan="1">67</td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1">130</td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> 3-year</td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1">49 (37–61)%</td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1">28 (20–36)%</td><td align="center" rowspan="1" colspan="1">0.058</td></tr><tr><td align="left" rowspan="1" colspan="1">Treatment related mortality</td><td align="center" rowspan="1" colspan="1">67</td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1">130</td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> 1-year</td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1">13 (6–23)%</td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1">36 (28–44)%</td><td align="center" rowspan="1" colspan="1"><0.001</td></tr><tr><td align="left" rowspan="1" colspan="1">Disease free survival</td><td align="center" rowspan="1" colspan="1">67</td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1">130</td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> 3-year</td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1">26 (16–37)%</td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1">28 (20–36)%</td><td align="center" rowspan="1" colspan="1">0.75</td></tr><tr><td align="left" rowspan="1" colspan="1">Overall survival</td><td align="center" rowspan="1" colspan="1">67</td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1">130</td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> 3-year</td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1">39 (27–52)%</td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1">35 (27–44)%</td><td align="center" rowspan="1" colspan="1">0.62</td></tr><tr><td align="left" rowspan="1" colspan="1">Acute GVHD, grade II – IV</td><td align="center" rowspan="1" colspan="1">66</td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1">130</td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> 100-day</td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1">30 (20–42)%</td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1">47 (39–56)%</td><td align="center" rowspan="1" colspan="1">0.014</td></tr><tr><td align="left" rowspan="1" colspan="1">Chronic GVHD at 3 years</td><td align="center" rowspan="1" colspan="1">66</td><td align="center" rowspan="1" colspan="1">60 (47–72)%</td><td align="center" rowspan="1" colspan="1">128</td><td align="center" rowspan="1" colspan="1">47 (38–56)%</td><td align="center" rowspan="1" colspan="1">0.17</td></tr></tbody></table></table-wrap><table-wrap id="T3" position="float" orientation="portrait"><label>Table 3</label><caption><p id="P43">Multivariate analysis of acute GVHD, chronic GVHD, treatment related mortality, relapse, disease free survival and overall survival</p></caption><table frame="box" rules="all"><thead><tr><th align="left" rowspan="1" colspan="1">Outcomes</th><th align="center" rowspan="1" colspan="1">N</th><th align="center" rowspan="1" colspan="1">HR (95% CI)</th><th align="right" rowspan="1" colspan="1">P-value</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1"><bold>Acute GVHD:</bold></td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1">Main effect:</td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> Myeloablative conditioning</td><td align="center" rowspan="1" colspan="1">130</td><td align="center" rowspan="1" colspan="1">1.00</td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> Reduced intensity conditioning</td><td align="center" rowspan="1" colspan="1">67</td><td align="center" rowspan="1" colspan="1">0.54 (0.33–0.88)</td><td align="right" rowspan="1" colspan="1">0.014</td></tr><tr><td align="left" rowspan="1" colspan="1"><bold>Chronic GVHD:</bold></td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1">Main effect:</td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> Myeloablative conditioning</td><td align="center" rowspan="1" colspan="1">130</td><td align="center" rowspan="1" colspan="1">1.00</td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> Reduced intensity conditioning</td><td align="center" rowspan="1" colspan="1">67</td><td align="center" rowspan="1" colspan="1">1.23 (0.81–1.86)</td><td align="right" rowspan="1" colspan="1">0.34</td></tr><tr><td align="left" rowspan="1" colspan="1">Other factors:</td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1">Pre HCT TKI</td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> Yes</td><td align="center" rowspan="1" colspan="1">153</td><td align="center" rowspan="1" colspan="1">1.00</td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> No</td><td align="center" rowspan="1" colspan="1">44</td><td align="center" rowspan="1" colspan="1">0.88 (0.53–1.45)</td><td align="right" rowspan="1" colspan="1">0.62</td></tr><tr><td align="left" rowspan="1" colspan="1"><bold>Treatment related mortality:</bold></td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1">Main effect:</td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> Myeloablative conditioning</td><td align="center" rowspan="1" colspan="1">130</td><td align="center" rowspan="1" colspan="1">1.00</td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> Reduced intensity conditioning</td><td align="center" rowspan="1" colspan="1">67</td><td align="center" rowspan="1" colspan="1">0.60 (0.35–1.02)</td><td align="right" rowspan="1" colspan="1">0.059</td></tr><tr><td align="left" rowspan="1" colspan="1">Other factors:</td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1">Age</td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> ≤ 40 years</td><td align="center" rowspan="1" colspan="1">42</td><td align="center" rowspan="1" colspan="1">1.00</td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> > 40</td><td align="center" rowspan="1" colspan="1">155</td><td align="center" rowspan="1" colspan="1">3.24 (1.45–7.24)</td><td align="right" rowspan="1" colspan="1">0.0042</td></tr><tr><td align="left" rowspan="1" colspan="1">Minimal residual disease*</td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> MRD<sup>neg</sup></td><td align="center" rowspan="1" colspan="1">84</td><td align="center" rowspan="1" colspan="1">1.00</td><td align="right" rowspan="1" colspan="1">P<sub>overall</sub>=0.33</td></tr><tr><td align="left" rowspan="1" colspan="1"> MRD<sup>pos</sup></td><td align="center" rowspan="1" colspan="1">101</td><td align="center" rowspan="1" colspan="1">0.72 (0.45–1.16)</td><td align="right" rowspan="1" colspan="1">0.18</td></tr><tr><td align="left" rowspan="1" colspan="1"> MRD unknown</td><td align="center" rowspan="1" colspan="1">12</td><td align="center" rowspan="1" colspan="1">0.65 (0.25–1.69)</td><td align="right" rowspan="1" colspan="1">0.37</td></tr><tr><td align="left" rowspan="1" colspan="1">Pre-HCT TKI</td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> Yes</td><td align="center" rowspan="1" colspan="1">153</td><td align="center" rowspan="1" colspan="1">1.00</td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> No</td><td align="center" rowspan="1" colspan="1">44</td><td align="center" rowspan="1" colspan="1">0.66 (0.38–1.15)</td><td align="right" rowspan="1" colspan="1">0.14</td></tr><tr><td align="left" rowspan="1" colspan="1">Chronic GVHD (time dependent)</td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> No</td><td align="center" rowspan="1" colspan="1">101</td><td align="center" rowspan="1" colspan="1">1.00</td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> Yes</td><td align="center" rowspan="1" colspan="1">96</td><td align="center" rowspan="1" colspan="1">1.74 (0.97–3.11)</td><td align="right" rowspan="1" colspan="1">0.064</td></tr><tr><td align="left" rowspan="1" colspan="1"><bold>Relapse:</bold></td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1">Main effect:</td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> Myeloablative conditioning</td><td align="center" rowspan="1" colspan="1">130</td><td align="center" rowspan="1" colspan="1">1.00</td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> Reduced intensity conditioning</td><td align="center" rowspan="1" colspan="1">67</td><td align="center" rowspan="1" colspan="1">1.84 (1.15–2.94)</td><td align="right" rowspan="1" colspan="1">0.011</td></tr><tr><td align="left" rowspan="1" colspan="1">Other factors:</td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1">Age</td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> ≤ 40 years</td><td align="center" rowspan="1" colspan="1">42</td><td align="center" rowspan="1" colspan="1">1.00</td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> > 40</td><td align="center" rowspan="1" colspan="1">155</td><td align="center" rowspan="1" colspan="1">1.02 (0.61–1.68)</td><td align="right" rowspan="1" colspan="1">0.95</td></tr><tr><td align="left" rowspan="1" colspan="1">Minimal residual disease*</td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> MRD<sup>neg</sup></td><td align="center" rowspan="1" colspan="1">84</td><td align="center" rowspan="1" colspan="1">1.00</td><td align="right" rowspan="1" colspan="1">P<sub>overall</sub>=0.13</td></tr><tr><td align="left" rowspan="1" colspan="1"> MRD<sup>pos</sup></td><td align="center" rowspan="1" colspan="1">101</td><td align="center" rowspan="1" colspan="1">1.60 (0.96–2.67)</td><td align="right" rowspan="1" colspan="1">0.070</td></tr><tr><td align="left" rowspan="1" colspan="1"> MRD unknown</td><td align="center" rowspan="1" colspan="1">12</td><td align="center" rowspan="1" colspan="1">0.77 (0.22–2.78)</td><td align="right" rowspan="1" colspan="1">0.69</td></tr><tr><td align="left" rowspan="1" colspan="1">Pre-HCT TKI</td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> Yes</td><td align="center" rowspan="1" colspan="1">153</td><td align="center" rowspan="1" colspan="1">1.00</td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> No</td><td align="center" rowspan="1" colspan="1">44</td><td align="center" rowspan="1" colspan="1">1.88 (1.11–3.17)</td><td align="right" rowspan="1" colspan="1">0.018</td></tr><tr><td align="left" rowspan="1" colspan="1">Chronic GVHD (time dependent)</td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> No</td><td align="center" rowspan="1" colspan="1">101</td><td align="center" rowspan="1" colspan="1">1.00</td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> Yes</td><td align="center" rowspan="1" colspan="1">96</td><td align="center" rowspan="1" colspan="1">0.72 (0.40–1.31)</td><td align="right" rowspan="1" colspan="1">0.28</td></tr><tr><td align="left" rowspan="1" colspan="1"><bold>Disease free survival:</bold></td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1">Main effect:</td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> Myeloablative conditioning</td><td align="center" rowspan="1" colspan="1">130</td><td align="center" rowspan="1" colspan="1">1.00</td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> Reduced intensity conditioning</td><td align="center" rowspan="1" colspan="1">67</td><td align="center" rowspan="1" colspan="1">1.08 (0.76–1.51)</td><td align="right" rowspan="1" colspan="1">0.68</td></tr><tr><td align="left" rowspan="1" colspan="1">Other factors:</td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1">Age</td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> ≤ 40 years</td><td align="center" rowspan="1" colspan="1">42</td><td align="center" rowspan="1" colspan="1">1.00</td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> > 40</td><td align="center" rowspan="1" colspan="1">155</td><td align="center" rowspan="1" colspan="1">1.68 (1.11–2.56)</td><td align="right" rowspan="1" colspan="1">0.015</td></tr><tr><td align="left" rowspan="1" colspan="1">Minimal residual disease*</td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> MRD<sup>neg</sup></td><td align="center" rowspan="1" colspan="1">84</td><td align="center" rowspan="1" colspan="1">1.00</td><td align="right" rowspan="1" colspan="1">P<sub>overall</sub>=0.56</td></tr><tr><td align="left" rowspan="1" colspan="1"> MRD<sup>pos</sup></td><td align="center" rowspan="1" colspan="1">101</td><td align="center" rowspan="1" colspan="1">1.06 (0.75–1.48)</td><td align="right" rowspan="1" colspan="1">0.75</td></tr><tr><td align="left" rowspan="1" colspan="1"> MRD unknown</td><td align="center" rowspan="1" colspan="1">12</td><td align="center" rowspan="1" colspan="1">0.67 (0.29–1.54)</td><td align="right" rowspan="1" colspan="1">0.35</td></tr><tr><td align="left" rowspan="1" colspan="1">Pre-HCT TKI</td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> Yes</td><td align="center" rowspan="1" colspan="1">153</td><td align="center" rowspan="1" colspan="1">1.00</td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> No</td><td align="center" rowspan="1" colspan="1">44</td><td align="center" rowspan="1" colspan="1">1.08 (0.75–1.54)</td><td align="right" rowspan="1" colspan="1">0.69</td></tr><tr><td align="left" rowspan="1" colspan="1">Chronic GVHD (time dependent)</td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> No</td><td align="center" rowspan="1" colspan="1">101</td><td align="center" rowspan="1" colspan="1">1.00</td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> Yes</td><td align="center" rowspan="1" colspan="1">96</td><td align="center" rowspan="1" colspan="1">1.02 (0.68–1.54)</td><td align="right" rowspan="1" colspan="1">0.92</td></tr><tr><td align="left" rowspan="1" colspan="1"><bold>Overall survival:</bold></td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1">Main effect:</td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> Myeloablative conditioning</td><td align="center" rowspan="1" colspan="1">130</td><td align="center" rowspan="1" colspan="1">1.00</td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> Reduced intensity conditioning</td><td align="center" rowspan="1" colspan="1">67</td><td align="center" rowspan="1" colspan="1">0.85 (0.59–1.24)</td><td align="right" rowspan="1" colspan="1">0.41</td></tr><tr><td align="left" rowspan="1" colspan="1">Other factors:</td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1">Age</td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> ≤ 40 years</td><td align="center" rowspan="1" colspan="1">42</td><td align="center" rowspan="1" colspan="1">1.00</td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> > 40</td><td align="center" rowspan="1" colspan="1">155</td><td align="center" rowspan="1" colspan="1">1.90 (1.19–3.04)</td><td align="right" rowspan="1" colspan="1">0.0070</td></tr><tr><td align="left" rowspan="1" colspan="1">Minimal residual disease*</td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> MRD<sup>neg</sup></td><td align="center" rowspan="1" colspan="1">84</td><td align="center" rowspan="1" colspan="1">1.00</td><td align="right" rowspan="1" colspan="1">P<sub>overall</sub>=0.66</td></tr><tr><td align="left" rowspan="1" colspan="1"> MRD<sup>pos</sup></td><td align="center" rowspan="1" colspan="1">101</td><td align="center" rowspan="1" colspan="1">0.94 (0.65–1.34)</td><td align="right" rowspan="1" colspan="1">0.71</td></tr><tr><td align="left" rowspan="1" colspan="1"> MRD unknown</td><td align="center" rowspan="1" colspan="1">12</td><td align="center" rowspan="1" colspan="1">0.67 (0.28–1.62)</td><td align="right" rowspan="1" colspan="1">0.37</td></tr><tr><td align="left" rowspan="1" colspan="1">Pre-HCT TKI</td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> Yes</td><td align="center" rowspan="1" colspan="1">153</td><td align="center" rowspan="1" colspan="1">1.00</td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> No</td><td align="center" rowspan="1" colspan="1">44</td><td align="center" rowspan="1" colspan="1">1.01 (0.69–1.48)</td><td align="right" rowspan="1" colspan="1">0.96</td></tr><tr><td align="left" rowspan="1" colspan="1">Chronic GVHD (time dependent)</td><td align="center" rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1"></td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> No</td><td align="center" rowspan="1" colspan="1">101</td><td align="center" rowspan="1" colspan="1">1.00</td><td align="right" rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1"> Yes</td><td align="center" rowspan="1" colspan="1">96</td><td align="center" rowspan="1" colspan="1">1.15 (0.77–1.74)</td><td align="right" rowspan="1" colspan="1">0.49</td></tr></tbody></table></table-wrap></floats-group></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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