> Details

Goldstone, Anthony H.; Richards, Susan M.; Lazarus, Hillard M.; Tallman, Martin S.; Buck, Georgina; Fielding, Adele K.; Burnett, Alan K.; Chopra, Raj; Wiernik, Peter H.; Foroni, Letizia; Paietta, Elisabeth; Litzow, Mark R.; Marks, David I.; Durrant, Jill; McMillan, Andrew; Franklin, Ian M.; Luger, Selina; Ciobanu, Niculae; Rowe, Jacob M.

In adults with standard-risk acute lymphoblastic leukemia, the greatest benefit is achieved from a matched sibling allogeneic transplantation in first complete remission, and an autologous transplantation is less effective than conventional consolidation/maintenance chemotherapy in all patients: final results of the International ALL Trial (MRC UKALL XII/ECOG E2993)

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  • Media type: E-Article
  • Title: In adults with standard-risk acute lymphoblastic leukemia, the greatest benefit is achieved from a matched sibling allogeneic transplantation in first complete remission, and an autologous transplantation is less effective than conventional consolidation/maintenance chemotherapy in all patients: final results of the International ALL Trial (MRC UKALL XII/ECOG E2993)
  • Contributor: Goldstone, Anthony H.; Richards, Susan M.; Lazarus, Hillard M.; Tallman, Martin S.; Buck, Georgina; Fielding, Adele K.; Burnett, Alan K.; Chopra, Raj; Wiernik, Peter H.; Foroni, Letizia; Paietta, Elisabeth; Litzow, Mark R.; Marks, David I.; Durrant, Jill; McMillan, Andrew; Franklin, Ian M.; Luger, Selina; Ciobanu, Niculae; Rowe, Jacob M.
  • imprint: American Society of Hematology, 2008
  • Published in: Blood
  • Language: English
  • DOI: 10.1182/blood-2007-10-116582
  • ISSN: 0006-4971; 1528-0020
  • Origination:
  • Footnote:
  • Description: <jats:p>An international collaboration was set up to prospectively evaluate the role of allogeneic transplantation for adults with acute lymphoblastic leukemia (ALL) and compare autologous transplantation with standard chemotherapy. Patients received 2 phases of induction and, if in remission, were assigned to allogeneic transplantation if they had a compatible sibling donor. Other patients were randomized to chemotherapy for 2.5 years versus an autologous transplantation. A donor versus no-donor analysis showed that Philadelphia chromosome–negative patients with a donor had a 5-year improved overall survival (OS), 53% versus 45% (P = .01), and the relapse rate was significantly lower (P ≤ .001). The survival difference was significant in standard-risk patients, but not in high-risk patients with a high nonrelapse mortality rate in the high-risk donor group. Patients randomized to chemotherapy had a higher 5-year OS (46%) than those randomized to autologous transplantation (37%; P = .03). Matched related allogeneic transplantations for ALL in first complete remission provide the most potent antileukemic therapy and considerable survival benefit for standard-risk patients. However, the transplantation-related mortality for high-risk older patients was unacceptably high and abrogated the reduction in relapse risk. There is no evidence that a single autologous transplantation can replace consolidation/maintenance in any risk group. This study is registered at http://clinicaltrials.gov as NCT00002514.</jats:p>
  • Access State: Open Access