scholarly journals Prophylactic donor lymphocyte infusion after allogeneic stem cell transplantation in acute leukaemia - a matched pair analysis by the Acute Leukaemia Working Party of EBMT

2018 ◽  
Vol 184 (5) ◽  
pp. 782-787 ◽  
Author(s):  
Christoph Schmid ◽  
Myriam Labopin ◽  
Nicolaas Schaap ◽  
Hendrik Veelken ◽  
Michael Schleuning ◽  
...  
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Allogeneic Stem Cell Transplantation ◽  
Acute Leukaemia ◽  
Working Party ◽  
Donor Lymphocyte Infusion ◽  
Matched Pair ◽  
Matched Pair Analysis ◽  
Pair Analysis

scholarly journals Autologous stem cell transplantation in patients of 70 years and older with multiple myeloma: Results from a matched pair analysis

2008 ◽  
Vol 83 (8) ◽  
pp. 614-617 ◽  
Author(s):  
Shaji K. Kumar ◽  
David Dingli ◽  
Martha Q. Lacy ◽  
Angela Dispenzieri ◽  
Suzanne R. Hayman ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Autologous Stem Cell Transplantation ◽  
Matched Pair ◽  
Matched Pair Analysis ◽  
Pair Analysis

Autologous or allogeneic stem cell transplantation versus chemotherapy in acute myeloid leukemia and subgroups: A multicenter trial by the German AML Cooperative Group

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 6556-6556
Author(s):  
T. Buchner ◽  
W. E. Berdel ◽  
J. Kienast ◽  
H. Kolb ◽  
P. Staib ◽  
...  
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Allogeneic Stem Cell Transplantation ◽  
De Novo ◽  
Multicenter Trial ◽  
Matched Pair ◽  
Secondary Aml ◽  
Matched Pair Analysis ◽  
Present Trial

6556 Background: From the data available the role of autologous and allogeneic stem cell transplantation (auto/allo SCT) versus post-remission chemotherapy appears uncertain and is readdressed in the present trial. Methods: Pts were stratified for cytogenetic groups, de-novo/secondary AML, LDH, WBC, and were up-front randomized in one step to induction by HAM-HAM vs TAD-HAM, and to G-CSF priming vs. no G-CSF. These two randomizations did not result in different outcome. Pts were also upfront randomized to auto SCT vs monthly maintenance chemotherapy. Within the two randomized arms pts with histocompatible family donors underwent priority allo SCT. Results: Since 1999 840 pts 16–60 y of age entered the trial. 14%, 62%, 21%, and 3% of pts had favorable, intermediate, unfavorable and unknown karyotype, and 19% had secondary AML. 70% of pts went into complete remission (CR). The probability of overall survival (OS) at 3 years in the auto SCT and the maintenance arm is 43% vs 41% (p=0.52), the relapse-free survival (RFS) is 40% vs 40% (p=0.78), and the ongoing remission duration (RD) is 48% vs 46% (p=0.65). Among pts alive and in CR 73% did receive auto SCT or maintenance or allo SCT, similar to previous trials (NEJM 332:217,1995, Blood 90:2978,1997, Lancet 351:700,1998, NEJM 339:1649,1998). The outcome according to therapy given in the auto SCT arm and the maintenance arm shows ongoing RD of 44% vs 50% (p=0.31), RFS of 44% vs 48% (p=0.35), and OS of 53% vs 69% (p=0.005). 128 pts underwent allo SCT. In a matched pair analysis with concordance of pairs in karyotype, de-novo/secondary AML, induction chemotherapy, and RFS at the time of SCT, RD shows a superiority of allo SCT (p<0.001), while OS is similar between the two arms (p=0.65). No prognostic subgroup with a special benefit from auto or allo SCT can be identified so far. Conclusions: Among current alternative strategies only novel approaches in allo SCT reducing the high transplant related death rate may further improve the cure of pts with AML and subgroups. No significant financial relationships to disclose.

The Outcomes Of Allogeneic Stem Cell Transplantation In Patients With Mixed Phenotype Acute Leukemia (MPAL) Are Comparable To Those In Acute Myeloid Leukemia (AML) and Acute Lymphoblastic Leukemia (ALL): Results Of a Matched-Pair Analysis

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 3403-3403
Author(s):  
Hiroaki Shimizu ◽  
Takayuki Saitoh ◽  
Shinichiro Machida ◽  
Shinichi Kako ◽  
Noriko Doki ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Acute Leukemia ◽  
Allogeneic Stem Cell Transplantation ◽  
Matched Pair ◽  
Matched Pair Analysis ◽  
Donor Bone Marrow ◽  
Significant Difference ◽  
Pair Analysis

Abstract Background MPAL is a rare subtype of acute leukemia that accounts for 2-5% of all acute leukemia cases. It has been reported that patients with MPAL tend to have worse prognosis compared with those with AML or ALL. However, the efficacy and safety of allogeneic stem cell transplantation (allo-SCT) for adult MPAL patients has yet to be elucidated. Objective The aim of this retrospective study was to assess the outcomes of allo-SCT for adult MPAL and compared with those for AML/ALL using a matched pair analysis method. Patients and Methods This study included patients over 15 years of age who were diagnosed with MPAL according to the WHO classification and underwent allo-SCT for the first time between January 2001 and December 2010. Their clinical data were collected from the database of the Kanto Study Group for Cell Therapy. The clinical features and transplant outcomes of MPAL patients were then compared with those of adult patients with AML, ALL, and Philadelphia chromosome-positive acute leukemia (Ph+AL). We selected control cohorts at the rate of one to five using an optimal matching method with the following seven matching factors: age, sex, disease status at the time of transplant, the intensity of conditioning, human leukocyte antigen disparity between donor and recipient, donor type (related or not), and time of transplant (2001-2005 or 2006-2010). Overall survival (OS) and relapse-free survival (RFS) rates was estimated by the Kaplan-Meier method and compared using the log-rank test. Cumulative incidences (CI) of relapse and non-relapse mortality (NRM) were compared using the stratified Gray test. P <0.05 was considered to represent statistical significance. Results Eighteen MPAL patients (9 men, 9 women) with a median age of 40 years (range, 16–61 years) were identified. Immunophenotypic analysis showed B+M phenotype in 12 patients, B+T phenotype in five, and B+T+M phenotype in one. Seven patients possessed Ph. Fourteen patients were in remission at the time of transplant. Sixteen patients were conditioned with myeloablative regimens. Stem cell sources were related donor bone marrow in four patients, unrelated donor bone marrow in 13, and cord blood in one. Among 18 MPAL patients, 5-year OS and RFS rates were 48.1% and 39.7%, respectively, and 5-year CI of relapse and NRM were 43.3% and 17.1%, respectively. Patients in remission at the time of transplant showed significantly better outcomes than those not in remission (5-year OS: 71.8% vs. 0%, p = 0.001; 5-year RFS: 58.7% vs. 0%, p = 0.004). By contrast, no significant difference was seen in OS and RFS when stratifying patients according to immunophenotype and cytogenetic abnormalities. In matched pair analysis, 90 AML, 90 ALL, and 35 Ph+AL patients were extracted from the database as control. The 5-year OS rate of MPAL patients was similar to those of AML patients (48.1% vs. 48.1%; p = 0.855) and ALL patients (48.1% vs. 37.8%; p = 0.426). Similarly, the 5-year OS rate of Ph+MPAL patients was not significantly different from that of Ph+AL patients (68.6% vs. 39.9%; p = 0.234). No significant difference was observed in RFS, CI of relapse, and CI of NRM when comparing MPAL patients with AML and ALL patients, and Ph+MPAL patients with Ph+AL patients. Conclusion Transplant outcomes of adult MPAL patients were comparable to those of both AML and ALL patients, although the statistical power was possibly insufficient due to the relatively small cohort. The existing transplant procedures were not satisfactory for MPAL patients who were not in remission at the time of transplant. On the other hand, MPAL patients who underwent allo-SCT while in remission showed excellent outcomes. Therefore, transplant early in the disease course may lead to improved outcomes for patients with this serious disease. Disclosures: No relevant conflicts of interest to declare.

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