Reduced intensity conditioned allograft yields favorable survival for older adults with B-cell acute lymphoblastic leukemia.
Identifieur interne : 001372 ( PubMed/Corpus ); précédent : 001371; suivant : 001373Reduced intensity conditioned allograft yields favorable survival for older adults with B-cell acute lymphoblastic leukemia.
Auteurs : Ashley Rosko ; Hai-Lin Wang ; Marcos De Lima ; Brenda Sandmaier ; H Jean Khoury ; Andrew Artz ; Johnathan Brammer ; Christopher Bredeson ; Sherif Farag ; Mohamed Kharfan-Dabaja ; Hillard M. Lazarus ; David I. Marks ; Rodrigo Martino Bufarull ; Joseph Mcguirk ; Mohamed Mohty ; Taiga Nishihori ; Ian Nivison-Smith ; Armin Rashidi ; Olle Ringden ; Matthew Seftel ; Daniel Weisdorf ; Veronika Bachanova ; Wael SaberSource :
- American journal of hematology [ 1096-8652 ] ; 2017.
English descriptors
- KwdEn :
- Aged, Disease-Free Survival, Female, Hematopoietic Stem Cell Transplantation (methods), Humans, Kaplan-Meier Estimate, Male, Middle Aged, Precursor B-Cell Lymphoblastic Leukemia-Lymphoma (epidemiology), Precursor B-Cell Lymphoblastic Leukemia-Lymphoma (therapy), Proportional Hazards Models, Recurrence, Retrospective Studies, Transplantation Conditioning (methods).
- MESH :
- epidemiology : Precursor B-Cell Lymphoblastic Leukemia-Lymphoma.
- methods : Hematopoietic Stem Cell Transplantation, Transplantation Conditioning.
- therapy : Precursor B-Cell Lymphoblastic Leukemia-Lymphoma.
- Aged, Disease-Free Survival, Female, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Proportional Hazards Models, Recurrence, Retrospective Studies.
Abstract
Older adults with B-cell acute lymphoblastic leukemia (B-ALL) have poor survival. We examined the effectiveness of reduced intensity conditioning (RIC) hematopoietic cell transplant (HCT) in adults with B-ALL age 55 years and older and explored prognostic factors associated with long-term outcomes. Using CIBMTR registry data, we evaluated 273 patients (median age 61, range 55-72) with B-ALL with disease status in CR1 (71%), >CR2 (17%) and Primary Induction Failure (PIF)/Relapse (11%), who underwent RIC HCT between 2001 and 2012 using mostly unrelated donor (59%) or HLA-matched sibling (32%). Among patients with available cytogenetic data, the Philadelphia chromosome (Ph+) was present in 50%. The 3-year cumulative incidences of nonrelapse mortality (NRM) and relapse were 25% (95% confidence intervals (CI): 20-31%) and 47% (95% CI: 41-53%), respectively. Three-year overall survival (OS) was 38% (95% CI: 33-44%). Relapse remained the leading cause of death accounting for 49% of all deaths. In univariate analysis, 3 year risk of NRM was significantly higher with reduced Karnofsky performance status (KPS <90: 34% (95% CI: 25-43%) versus KPS ≥90 (18%; 95% CI: 12-24%, P = 0.006). Mortality was increased in older adults (66+ vs. 55-60: Relative Risk [RR] 1.51 95% CI: 1.00-2.29, P = 0.05) and those with advanced disease (RR 2.13; 95% CI: 1.36-3.34, P = 0.001). Survival of patients in CR1 yields 45% (95% CI: 38-52%) at 3 years and no relapse occurred after 2 years. We report promising OS and acceptable NRM using RIC HCT in older patients with B-ALL. Disease status in CR1 and good performance status are associated with improved outcomes. Am. J. Hematol. 92:42-49, 2017. © 2016 Wiley Periodicals, Inc.
DOI: 10.1002/ajh.24575
PubMed: 27712033
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Reduced intensity conditioned allograft yields favorable survival for older adults with B-cell acute lymphoblastic leukemia.</title><author><name sortKey="Rosko, Ashley" sort="Rosko, Ashley" uniqKey="Rosko A" first="Ashley" last="Rosko">Ashley Rosko</name><affiliation><nlm:affiliation>James Cancer Center, Ohio State University, Columbus, OH.</nlm:affiliation></affiliation></author><author><name sortKey="Wang, Hai Lin" sort="Wang, Hai Lin" uniqKey="Wang H" first="Hai-Lin" last="Wang">Hai-Lin Wang</name><affiliation><nlm:affiliation>CIBMTR (Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI.</nlm:affiliation></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><nlm:affiliation>Department of Medicine, Seidman Cancer Center, University Hospitals Case Medical Center, Cleveland, OH.</nlm:affiliation></affiliation></author><author><name sortKey="Sandmaier, Brenda" sort="Sandmaier, Brenda" uniqKey="Sandmaier B" first="Brenda" last="Sandmaier">Brenda Sandmaier</name><affiliation><nlm:affiliation>Division of Medical Oncology, University of Washington and Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA.</nlm:affiliation></affiliation></author><author><name sortKey="Khoury, H Jean" sort="Khoury, H Jean" uniqKey="Khoury H" first="H Jean" last="Khoury">H Jean Khoury</name><affiliation><nlm:affiliation>Emory University Hospital, Atlanta, GA.</nlm:affiliation></affiliation></author><author><name sortKey="Artz, Andrew" sort="Artz, Andrew" uniqKey="Artz A" first="Andrew" last="Artz">Andrew Artz</name><affiliation><nlm:affiliation>Section of Hematology/Oncology, University of Chicago School of Medicine, Chicago, IL.</nlm:affiliation></affiliation></author><author><name sortKey="Brammer, Johnathan" sort="Brammer, Johnathan" uniqKey="Brammer J" first="Johnathan" last="Brammer">Johnathan Brammer</name><affiliation><nlm:affiliation>M.D. Anderson Cancer Center, Houston, TX.</nlm:affiliation></affiliation></author><author><name sortKey="Bredeson, Christopher" sort="Bredeson, Christopher" uniqKey="Bredeson C" first="Christopher" last="Bredeson">Christopher Bredeson</name><affiliation><nlm:affiliation>The Ottawa Hospital Blood and Marrow Transplant Program and the Ottawa Hospital Research Institute, Ottawa, ON, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Farag, Sherif" sort="Farag, Sherif" uniqKey="Farag S" first="Sherif" last="Farag">Sherif Farag</name><affiliation><nlm:affiliation>Indiana University Hospital/ Riley Hospital for Children, Indianapolis, IN.</nlm:affiliation></affiliation></author><author><name sortKey="Kharfan Dabaja, Mohamed" sort="Kharfan Dabaja, Mohamed" uniqKey="Kharfan Dabaja M" first="Mohamed" last="Kharfan-Dabaja">Mohamed Kharfan-Dabaja</name><affiliation><nlm:affiliation>Department of Blood and Marrow Transplantation, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL.</nlm:affiliation></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><nlm:affiliation>Seidman Cancer Center, University Hospitals Case Medical Center, Cleveland, OH.</nlm:affiliation></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><nlm:affiliation>Adult Bone Marrow Transplant, University Hospitals Bristol NHS Trust, Bristol, United Kingdom.</nlm:affiliation></affiliation></author><author><name sortKey="Bufarull, Rodrigo Martino" sort="Bufarull, Rodrigo Martino" uniqKey="Bufarull R" first="Rodrigo Martino" last="Bufarull">Rodrigo Martino Bufarull</name><affiliation><nlm:affiliation>Division of Clinical Hematology, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Mcguirk, Joseph" sort="Mcguirk, Joseph" uniqKey="Mcguirk J" first="Joseph" last="Mcguirk">Joseph Mcguirk</name><affiliation><nlm:affiliation>University of Kansas, Westwood, KS.</nlm:affiliation></affiliation></author><author><name sortKey="Mohty, Mohamed" sort="Mohty, Mohamed" uniqKey="Mohty M" first="Mohamed" last="Mohty">Mohamed Mohty</name><affiliation><nlm:affiliation>Hopital Saint-Antoine, APHP, Universite Pierre & Marie Curie, INSERM UMRs U938, Paris, France.</nlm:affiliation></affiliation></author><author><name sortKey="Nishihori, Taiga" sort="Nishihori, Taiga" uniqKey="Nishihori T" first="Taiga" last="Nishihori">Taiga Nishihori</name><affiliation><nlm:affiliation>Department of Blood and Marrow Transplantation, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL.</nlm:affiliation></affiliation></author><author><name sortKey="Nivison Smith, Ian" sort="Nivison Smith, Ian" uniqKey="Nivison Smith I" first="Ian" last="Nivison-Smith">Ian Nivison-Smith</name><affiliation><nlm:affiliation>St. Vincent's Hospital, Darlinghurst, NSW, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Rashidi, Armin" sort="Rashidi, Armin" uniqKey="Rashidi A" first="Armin" last="Rashidi">Armin Rashidi</name><affiliation><nlm:affiliation>Barnes Jewish Hospital, St. Louis, MO.</nlm:affiliation></affiliation></author><author><name sortKey="Ringden, Olle" sort="Ringden, Olle" uniqKey="Ringden O" first="Olle" last="Ringden">Olle Ringden</name><affiliation><nlm:affiliation>Division of Therapeutic Immunology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.</nlm:affiliation></affiliation></author><author><name sortKey="Seftel, Matthew" sort="Seftel, Matthew" uniqKey="Seftel M" first="Matthew" last="Seftel">Matthew Seftel</name><affiliation><nlm:affiliation>Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Weisdorf, Daniel" sort="Weisdorf, Daniel" uniqKey="Weisdorf D" first="Daniel" last="Weisdorf">Daniel Weisdorf</name><affiliation><nlm:affiliation>Divsion of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota Medical Center, Minneapolis, MN.</nlm:affiliation></affiliation></author><author><name sortKey="Bachanova, Veronika" sort="Bachanova, Veronika" uniqKey="Bachanova V" first="Veronika" last="Bachanova">Veronika Bachanova</name><affiliation><nlm:affiliation>Bone and Marrow Transplant Program, University of Minnesota Medical Center, Minneapolis, MN.</nlm:affiliation></affiliation></author><author><name sortKey="Saber, Wael" sort="Saber, Wael" uniqKey="Saber W" first="Wael" last="Saber">Wael Saber</name><affiliation><nlm:affiliation>CIBMTR (Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2017">2017</date><idno type="RBID">pubmed:27712033</idno><idno type="pmid">27712033</idno><idno type="doi">10.1002/ajh.24575</idno><idno type="wicri:Area/PubMed/Corpus">001372</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">001372</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Reduced intensity conditioned allograft yields favorable survival for older adults with B-cell acute lymphoblastic leukemia.</title><author><name sortKey="Rosko, Ashley" sort="Rosko, Ashley" uniqKey="Rosko A" first="Ashley" last="Rosko">Ashley Rosko</name><affiliation><nlm:affiliation>James Cancer Center, Ohio State University, Columbus, OH.</nlm:affiliation></affiliation></author><author><name sortKey="Wang, Hai Lin" sort="Wang, Hai Lin" uniqKey="Wang H" first="Hai-Lin" last="Wang">Hai-Lin Wang</name><affiliation><nlm:affiliation>CIBMTR (Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI.</nlm:affiliation></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><nlm:affiliation>Department of Medicine, Seidman Cancer Center, University Hospitals Case Medical Center, Cleveland, OH.</nlm:affiliation></affiliation></author><author><name sortKey="Sandmaier, Brenda" sort="Sandmaier, Brenda" uniqKey="Sandmaier B" first="Brenda" last="Sandmaier">Brenda Sandmaier</name><affiliation><nlm:affiliation>Division of Medical Oncology, University of Washington and Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA.</nlm:affiliation></affiliation></author><author><name sortKey="Khoury, H Jean" sort="Khoury, H Jean" uniqKey="Khoury H" first="H Jean" last="Khoury">H Jean Khoury</name><affiliation><nlm:affiliation>Emory University Hospital, Atlanta, GA.</nlm:affiliation></affiliation></author><author><name sortKey="Artz, Andrew" sort="Artz, Andrew" uniqKey="Artz A" first="Andrew" last="Artz">Andrew Artz</name><affiliation><nlm:affiliation>Section of Hematology/Oncology, University of Chicago School of Medicine, Chicago, IL.</nlm:affiliation></affiliation></author><author><name sortKey="Brammer, Johnathan" sort="Brammer, Johnathan" uniqKey="Brammer J" first="Johnathan" last="Brammer">Johnathan Brammer</name><affiliation><nlm:affiliation>M.D. Anderson Cancer Center, Houston, TX.</nlm:affiliation></affiliation></author><author><name sortKey="Bredeson, Christopher" sort="Bredeson, Christopher" uniqKey="Bredeson C" first="Christopher" last="Bredeson">Christopher Bredeson</name><affiliation><nlm:affiliation>The Ottawa Hospital Blood and Marrow Transplant Program and the Ottawa Hospital Research Institute, Ottawa, ON, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Farag, Sherif" sort="Farag, Sherif" uniqKey="Farag S" first="Sherif" last="Farag">Sherif Farag</name><affiliation><nlm:affiliation>Indiana University Hospital/ Riley Hospital for Children, Indianapolis, IN.</nlm:affiliation></affiliation></author><author><name sortKey="Kharfan Dabaja, Mohamed" sort="Kharfan Dabaja, Mohamed" uniqKey="Kharfan Dabaja M" first="Mohamed" last="Kharfan-Dabaja">Mohamed Kharfan-Dabaja</name><affiliation><nlm:affiliation>Department of Blood and Marrow Transplantation, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL.</nlm:affiliation></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><nlm:affiliation>Seidman Cancer Center, University Hospitals Case Medical Center, Cleveland, OH.</nlm:affiliation></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><nlm:affiliation>Adult Bone Marrow Transplant, University Hospitals Bristol NHS Trust, Bristol, United Kingdom.</nlm:affiliation></affiliation></author><author><name sortKey="Bufarull, Rodrigo Martino" sort="Bufarull, Rodrigo Martino" uniqKey="Bufarull R" first="Rodrigo Martino" last="Bufarull">Rodrigo Martino Bufarull</name><affiliation><nlm:affiliation>Division of Clinical Hematology, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain.</nlm:affiliation></affiliation></author><author><name sortKey="Mcguirk, Joseph" sort="Mcguirk, Joseph" uniqKey="Mcguirk J" first="Joseph" last="Mcguirk">Joseph Mcguirk</name><affiliation><nlm:affiliation>University of Kansas, Westwood, KS.</nlm:affiliation></affiliation></author><author><name sortKey="Mohty, Mohamed" sort="Mohty, Mohamed" uniqKey="Mohty M" first="Mohamed" last="Mohty">Mohamed Mohty</name><affiliation><nlm:affiliation>Hopital Saint-Antoine, APHP, Universite Pierre & Marie Curie, INSERM UMRs U938, Paris, France.</nlm:affiliation></affiliation></author><author><name sortKey="Nishihori, Taiga" sort="Nishihori, Taiga" uniqKey="Nishihori T" first="Taiga" last="Nishihori">Taiga Nishihori</name><affiliation><nlm:affiliation>Department of Blood and Marrow Transplantation, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL.</nlm:affiliation></affiliation></author><author><name sortKey="Nivison Smith, Ian" sort="Nivison Smith, Ian" uniqKey="Nivison Smith I" first="Ian" last="Nivison-Smith">Ian Nivison-Smith</name><affiliation><nlm:affiliation>St. Vincent's Hospital, Darlinghurst, NSW, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Rashidi, Armin" sort="Rashidi, Armin" uniqKey="Rashidi A" first="Armin" last="Rashidi">Armin Rashidi</name><affiliation><nlm:affiliation>Barnes Jewish Hospital, St. Louis, MO.</nlm:affiliation></affiliation></author><author><name sortKey="Ringden, Olle" sort="Ringden, Olle" uniqKey="Ringden O" first="Olle" last="Ringden">Olle Ringden</name><affiliation><nlm:affiliation>Division of Therapeutic Immunology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.</nlm:affiliation></affiliation></author><author><name sortKey="Seftel, Matthew" sort="Seftel, Matthew" uniqKey="Seftel M" first="Matthew" last="Seftel">Matthew Seftel</name><affiliation><nlm:affiliation>Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Weisdorf, Daniel" sort="Weisdorf, Daniel" uniqKey="Weisdorf D" first="Daniel" last="Weisdorf">Daniel Weisdorf</name><affiliation><nlm:affiliation>Divsion of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota Medical Center, Minneapolis, MN.</nlm:affiliation></affiliation></author><author><name sortKey="Bachanova, Veronika" sort="Bachanova, Veronika" uniqKey="Bachanova V" first="Veronika" last="Bachanova">Veronika Bachanova</name><affiliation><nlm:affiliation>Bone and Marrow Transplant Program, University of Minnesota Medical Center, Minneapolis, MN.</nlm:affiliation></affiliation></author><author><name sortKey="Saber, Wael" sort="Saber, Wael" uniqKey="Saber W" first="Wael" last="Saber">Wael Saber</name><affiliation><nlm:affiliation>CIBMTR (Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI.</nlm:affiliation></affiliation></author></analytic><series><title level="j">American journal of hematology</title><idno type="eISSN">1096-8652</idno><imprint><date when="2017" type="published">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Disease-Free Survival</term><term>Female</term><term>Hematopoietic Stem Cell Transplantation (methods)</term><term>Humans</term><term>Kaplan-Meier Estimate</term><term>Male</term><term>Middle Aged</term><term>Precursor B-Cell Lymphoblastic Leukemia-Lymphoma (epidemiology)</term><term>Precursor B-Cell Lymphoblastic Leukemia-Lymphoma (therapy)</term><term>Proportional Hazards Models</term><term>Recurrence</term><term>Retrospective Studies</term><term>Transplantation Conditioning (methods)</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Precursor B-Cell Lymphoblastic Leukemia-Lymphoma</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Hematopoietic Stem Cell Transplantation</term><term>Transplantation Conditioning</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Precursor B-Cell Lymphoblastic Leukemia-Lymphoma</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Disease-Free Survival</term><term>Female</term><term>Humans</term><term>Kaplan-Meier Estimate</term><term>Male</term><term>Middle Aged</term><term>Proportional Hazards Models</term><term>Recurrence</term><term>Retrospective Studies</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Older adults with B-cell acute lymphoblastic leukemia (B-ALL) have poor survival. We examined the effectiveness of reduced intensity conditioning (RIC) hematopoietic cell transplant (HCT) in adults with B-ALL age 55 years and older and explored prognostic factors associated with long-term outcomes. Using CIBMTR registry data, we evaluated 273 patients (median age 61, range 55-72) with B-ALL with disease status in CR1 (71%), >CR2 (17%) and Primary Induction Failure (PIF)/Relapse (11%), who underwent RIC HCT between 2001 and 2012 using mostly unrelated donor (59%) or HLA-matched sibling (32%). Among patients with available cytogenetic data, the Philadelphia chromosome (Ph+) was present in 50%. The 3-year cumulative incidences of nonrelapse mortality (NRM) and relapse were 25% (95% confidence intervals (CI): 20-31%) and 47% (95% CI: 41-53%), respectively. Three-year overall survival (OS) was 38% (95% CI: 33-44%). Relapse remained the leading cause of death accounting for 49% of all deaths. In univariate analysis, 3 year risk of NRM was significantly higher with reduced Karnofsky performance status (KPS <90: 34% (95% CI: 25-43%) versus KPS ≥90 (18%; 95% CI: 12-24%, P = 0.006). Mortality was increased in older adults (66+ vs. 55-60: Relative Risk [RR] 1.51 95% CI: 1.00-2.29, P = 0.05) and those with advanced disease (RR 2.13; 95% CI: 1.36-3.34, P = 0.001). Survival of patients in CR1 yields 45% (95% CI: 38-52%) at 3 years and no relapse occurred after 2 years. We report promising OS and acceptable NRM using RIC HCT in older patients with B-ALL. Disease status in CR1 and good performance status are associated with improved outcomes. Am. J. Hematol. 92:42-49, 2017. © 2016 Wiley Periodicals, Inc.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">27712033</PMID><DateCreated><Year>2016</Year><Month>10</Month><Day>06</Day></DateCreated><DateCompleted><Year>2017</Year><Month>07</Month><Day>06</Day></DateCompleted><DateRevised><Year>2017</Year><Month>07</Month><Day>18</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1096-8652</ISSN><JournalIssue CitedMedium="Internet"><Volume>92</Volume><Issue>1</Issue><PubDate><Year>2017</Year><Month>Jan</Month></PubDate></JournalIssue><Title>American journal of hematology</Title><ISOAbbreviation>Am. J. Hematol.</ISOAbbreviation></Journal><ArticleTitle>Reduced intensity conditioned allograft yields favorable survival for older adults with B-cell acute lymphoblastic leukemia.</ArticleTitle><Pagination><MedlinePgn>42-49</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1002/ajh.24575</ELocationID><Abstract><AbstractText>Older adults with B-cell acute lymphoblastic leukemia (B-ALL) have poor survival. We examined the effectiveness of reduced intensity conditioning (RIC) hematopoietic cell transplant (HCT) in adults with B-ALL age 55 years and older and explored prognostic factors associated with long-term outcomes. Using CIBMTR registry data, we evaluated 273 patients (median age 61, range 55-72) with B-ALL with disease status in CR1 (71%), >CR2 (17%) and Primary Induction Failure (PIF)/Relapse (11%), who underwent RIC HCT between 2001 and 2012 using mostly unrelated donor (59%) or HLA-matched sibling (32%). Among patients with available cytogenetic data, the Philadelphia chromosome (Ph+) was present in 50%. The 3-year cumulative incidences of nonrelapse mortality (NRM) and relapse were 25% (95% confidence intervals (CI): 20-31%) and 47% (95% CI: 41-53%), respectively. Three-year overall survival (OS) was 38% (95% CI: 33-44%). Relapse remained the leading cause of death accounting for 49% of all deaths. In univariate analysis, 3 year risk of NRM was significantly higher with reduced Karnofsky performance status (KPS <90: 34% (95% CI: 25-43%) versus KPS ≥90 (18%; 95% CI: 12-24%, P = 0.006). Mortality was increased in older adults (66+ vs. 55-60: Relative Risk [RR] 1.51 95% CI: 1.00-2.29, P = 0.05) and those with advanced disease (RR 2.13; 95% CI: 1.36-3.34, P = 0.001). Survival of patients in CR1 yields 45% (95% CI: 38-52%) at 3 years and no relapse occurred after 2 years. We report promising OS and acceptable NRM using RIC HCT in older patients with B-ALL. Disease status in CR1 and good performance status are associated with improved outcomes. Am. J. Hematol. 92:42-49, 2017. © 2016 Wiley Periodicals, Inc.</AbstractText><CopyrightInformation>© 2016 Wiley Periodicals, Inc.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Rosko</LastName><ForeName>Ashley</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>James Cancer Center, Ohio State University, Columbus, OH.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wang</LastName><ForeName>Hai-Lin</ForeName><Initials>HL</Initials><AffiliationInfo><Affiliation>CIBMTR (Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>de Lima</LastName><ForeName>Marcos</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Medicine, Seidman Cancer Center, University Hospitals Case Medical Center, Cleveland, OH.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sandmaier</LastName><ForeName>Brenda</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Division of Medical Oncology, University of Washington and Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Khoury</LastName><ForeName>H Jean</ForeName><Initials>HJ</Initials><AffiliationInfo><Affiliation>Emory University Hospital, Atlanta, GA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Artz</LastName><ForeName>Andrew</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Section of Hematology/Oncology, University of Chicago School of Medicine, Chicago, IL.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Brammer</LastName><ForeName>Johnathan</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>M.D. Anderson Cancer Center, Houston, TX.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bredeson</LastName><ForeName>Christopher</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>The Ottawa Hospital Blood and Marrow Transplant Program and the Ottawa Hospital Research Institute, Ottawa, ON, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Farag</LastName><ForeName>Sherif</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Indiana University Hospital/ Riley Hospital for Children, Indianapolis, IN.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kharfan-Dabaja</LastName><ForeName>Mohamed</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Blood and Marrow Transplantation, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lazarus</LastName><ForeName>Hillard M</ForeName><Initials>HM</Initials><AffiliationInfo><Affiliation>Seidman Cancer Center, University Hospitals Case Medical Center, Cleveland, OH.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Marks</LastName><ForeName>David I</ForeName><Initials>DI</Initials><AffiliationInfo><Affiliation>Adult Bone Marrow Transplant, University Hospitals Bristol NHS Trust, Bristol, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bufarull</LastName><ForeName>Rodrigo Martino</ForeName><Initials>RM</Initials><AffiliationInfo><Affiliation>Division of Clinical Hematology, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>McGuirk</LastName><ForeName>Joseph</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>University of Kansas, Westwood, KS.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mohty</LastName><ForeName>Mohamed</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Hopital Saint-Antoine, APHP, Universite Pierre & Marie Curie, INSERM UMRs U938, Paris, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Nishihori</LastName><ForeName>Taiga</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Department of Blood and Marrow Transplantation, H. Lee Moffit Cancer Center and Research Institute, Tampa, FL.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Nivison-Smith</LastName><ForeName>Ian</ForeName><Initials>I</Initials><AffiliationInfo><Affiliation>St. Vincent's Hospital, Darlinghurst, NSW, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rashidi</LastName><ForeName>Armin</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Barnes Jewish Hospital, St. Louis, MO.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ringden</LastName><ForeName>Olle</ForeName><Initials>O</Initials><AffiliationInfo><Affiliation>Division of Therapeutic Immunology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Centre for Allogeneic Stem Cell Transplantation, Stockholm, Sweden.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Seftel</LastName><ForeName>Matthew</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Weisdorf</LastName><ForeName>Daniel</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Divsion of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota Medical Center, Minneapolis, MN.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y" EqualContrib="Y"><LastName>Bachanova</LastName><ForeName>Veronika</ForeName><Initials>V</Initials><AffiliationInfo><Affiliation>Bone and Marrow Transplant Program, University of Minnesota Medical Center, Minneapolis, MN.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y" EqualContrib="Y"><LastName>Saber</LastName><ForeName>Wael</ForeName><Initials>W</Initials><AffiliationInfo><Affiliation>CIBMTR (Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>U10 HL069294</GrantID><Acronym>HL</Acronym><Agency>NHLBI NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>U24 CA076518</GrantID><Acronym>CA</Acronym><Agency>NCI NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>UL1 TR000114</GrantID><Acronym>TR</Acronym><Agency>NCATS NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>KL2 TR000113</GrantID><Acronym>TR</Acronym><Agency>NCATS NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>K23 CA208010</GrantID><Acronym>CA</Acronym><Agency>NCI NIH HHS</Agency><Country>United States</Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016448">Multicenter Study</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2016</Year><Month>11</Month><Day>12</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Am J Hematol</MedlineTA><NlmUniqueID>7610369</NlmUniqueID><ISSNLinking>0361-8609</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="Cites"><RefSource>Ann Oncol. 2013 Jun;24(6):1594-602</RefSource><PMID Version="1">23372050</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>J Natl Compr Canc Netw. 2015 Sep;13(9):1120-30</RefSource><PMID Version="1">26358796</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Bone Marrow Transplant. 2002 Feb;29(3):191-5</RefSource><PMID Version="1">11859390</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>J Clin Oncol. 2011 Sep 1;29(25):3457-65</RefSource><PMID 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1;106(12):3760-7</RefSource><PMID Version="1">16105981</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018572" MajorTopicYN="N">Disease-Free Survival</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018380" MajorTopicYN="N">Hematopoietic Stem Cell Transplantation</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D053208" MajorTopicYN="N">Kaplan-Meier Estimate</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015452" MajorTopicYN="N">Precursor B-Cell Lymphoblastic Leukemia-Lymphoma</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016016" MajorTopicYN="N">Proportional Hazards Models</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012008" MajorTopicYN="N">Recurrence</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D019172" MajorTopicYN="N">Transplantation Conditioning</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2016</Year><Month>07</Month><Day>15</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2016</Year><Month>09</Month><Day>30</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2016</Year><Month>10</Month><Day>03</Day></PubMedPubDate><PubMedPubDate PubStatus="pmc-release"><Year>2018</Year><Month>01</Month><Day>01</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2016</Year><Month>10</Month><Day>7</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2017</Year><Month>7</Month><Day>7</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2016</Year><Month>10</Month><Day>7</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">27712033</ArticleId><ArticleId IdType="doi">10.1002/ajh.24575</ArticleId><ArticleId IdType="pmc">PMC5167625</ArticleId><ArticleId IdType="mid">NIHMS821775</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce 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