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Thiotepa‐based conditioning for allogeneic stem cell transplantation in acute lymphoblastic leukemia—A survey from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation
Author(s) -
Eder Sandra,
Beohou Eric,
Labopin Myriam,
Sanz Jaime,
Finke Jürgen,
Arcese William,
Or Reuven,
Bonifazi Francesca,
Aljurf Mahmoud,
Socié Gerard,
Passweg Jakob,
Giebel Sebastian,
Mohty Mohamad,
Nagler Ar
Publication year - 2017
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.24567
Subject(s) - thiotepa , medicine , lymphoblastic leukemia , transplantation , acute leukemia , leukemia , conditioning , oncology , stem cell , chemotherapy , cyclophosphamide , biology , statistics , mathematics , genetics
In this study, we analyzed a thiotepa‐based conditioning regimen for allogeneic stem cell transplantation in adults with acute lymphoblastic leukemia, using the EBMT database. A total of 323 patients were identified. The median age was 43 years. Disease status at transplant was first complete remission (CR1) in 48.9%, CR2 in 21.7%, CR3 in 6.2%, while 23.2% of the patients had an active disease at the time of transplant. This was performed from a HLA‐matched sibling (49.8%) or a matched‐unrelated donor (51.2%). The incidence of acute graft‐vs.‐host disease (GvHD) (grade > II) was 26.6%, while chronic GvHD occurred in 35.9% of the patients at 1 year (24.6% with extensive disease). With a median follow‐up of 16.8 months, the nonrelapse mortality was 12.4 and 25.3% at 100 days and 1 year, respectively. The relapse incidence at 1 year was 33.3% with no difference for patients in CR1 (27%). The one‐year leukemia‐free survival (LFS) and overall survival (OS) were 57 and 66%, respectively for the entire cohort and 50 and 66%, respectively in patients in CR1. Thiotepa/busulfan ± melphalan ( n = 213) in comparison to thiotepa/other ( n = 110) conditioning regimen resulted in higher relapse incidence at 1 year (34.9 vs. 30.3%, P = 0.016) and lower LFS (38.8 vs. 45.9%, P = 0.0203), while nonrelapse mortality (23.8 vs. 26.3%, n.s.) and OS (59.6 vs. 51.1%, P = 0.109) did not differ. This large study suggests that a thiotepa‐based conditioning for allogeneic transplantation in acute lymphoblastic leukemia is feasible and effective, with the main outcomes being comparable to those achieved with other regimens. Am. J. Hematol. 92:18–22, 2017. © 2016 Wiley Periodicals, Inc.