TANAKA Junji
   Department   Other, Other
   Position  
Article types Original article
Language English
Peer review Peer reviewed
Title Reduced-intensity conditioning is a reasonable alternative for Philadelphia chromosome-positive acute lymphoblastic leukemia among elderly patients who have achieved negative minimal residual disease: a report from the Adult Acute Lymphoblastic Leukemia Working Group of the JSHCT.
Journal Formal name：Bone marrow transplantation
Abbreviation：Bone Marrow Transplant
ISSN code：14765365/02683369
Domestic / ForeginForegin
Volume, Issue, Page 55(7),pp.1317-1325
Author and coauthor Akahoshi Yu†, Nishiwaki Satoshi, Arai Yasuyuki, Harada Kaito, Najima Yuho, Kanda Yoshinobu, Shono Katsuhiro, Ota Shuichi, Fukuda Takahiro, Uchida Naoyuki, Shiratori Souichi, Tanaka Masatsugu, Tanaka Junji, Atsuta Yoshiko, Kako Shinichi
Publication date 2020/07
Summary Reduced-intensity conditioning (RIC) regimens have been widely used for allogeneic hematopoietic cell transplantation (HCT) in elderly patients. After the emergence of tyrosine kinase inhibitor (TKI), most patients with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph-positive ALL) now achieve negative results for minimal residual disease (MRD) at HCT. In this study, we evaluated patients aged 50 years or more with Ph-positive ALL who received TKI before HCT, achieved negative-MRD at HCT, and underwent their first allogeneic HCT between 2008 and 2017. In total, 90 and 136 patients who received myeloablative conditioning (MAC) and a RIC regimen, respectively, were included. The median age of patients with MAC and RIC was 54 and 60 years, respectively. Even in multivariate analyses, RIC was not significantly associated with overall mortality (hazard ratio [HR], 1.09; P = 0.724), hematological relapse (HR, 1.97; P = 0.170), or non-relapse mortality (HR, 0.84; P = 0.540). Subgroup analyses suggested that RIC resulted in superior overall survival due to a lower incidence of non-relapse mortality in patients with a poor performance status or a high HCT comorbidity index. In conclusion, RIC is a reasonable option for elderly patients with negative-MRD at HCT.
DOI 10.1038/s41409-020-0951-0
PMID 32447350