Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Review
  • Published:

Allogeneic hematopoietic cell transplantation for adults with ALL

Bone Marrow Transplantation volume 42, pages S18–S24 (2008)Cite this article

Abstract

ALL is a heterogeneous disease, and outcomes vary by patient age, immunophenotype and clinical, cytogenetic and molecular features. Modern treatment strategies use a risk-adapted approach. The optimal post-remission therapy for adults with ALL remains unclear. Available data indicate no consensus as to whether there is an advantage to allogeneic hematopoietic cell transplant (Allo-HCT) over chemotherapy for the consolidation of adults with ALL with standard risk features while in the first CR (CR1). However, Allo-HCT is recommended in CR1 for patients with high-risk ALL, for those in a second CR (CR2) and for certain other subsets of patients with this disease.

Access through your institution
Buy or subscribe

This is a preview of subscription content, access via your institution

Access options

Access through your institution

Buy this article

  • Purchase on SpringerLink
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Larson RA, Dodge RK, Bloomfield CD, Schiffer CA . Treatment of biologically determined subsets of acute lymphoblastic leukemia in adults: Cancer and Leukemia Group B studies. In: Buchner T, Hiddemann W, Wormann B et al. (eds). Acute Leukemias VI: Prognostic factors and treatment strategies. Springer-Verlag: Berlin, 1997, pp 677–686.

    Chapter  Google Scholar 

  2. Hoelzer D, Thiel E, Loffler H, Büchner T, Ganser A, Heil G et al. Prognostic factors in a multicenter study for treatment of acute lymphoblastic leukemia in adults. Blood 1988; 71: 123–131.

    CAS  PubMed  Google Scholar 

  3. DeAngelo DJ . The treatment of adolescents and young adults with acute lymphoblastic leukemia. Hematology Am Soc Hematol Educ Program 2005, 123–130.

    Article  Google Scholar 

  4. Hahn T, Wall D, Camitta B, Davies S, Dillon H, Gaynon R et al. The role of cytotoxic therapy with hematopoietic stem cell transplantation in the therapy of acute lymphoblastic leukemia in adults: an evidence-based review. Biol Blood Marrow Transplant 2006; 12: 1–30.

    Article  CAS  PubMed  Google Scholar 

  5. Fiere D, Lepage E, Sebban C, Boucheix C, Gisselbrecht C, Vernant JP et al. Adult acute lymphoblastic leukemia: a multicentric randomized trial testing bone marrow transplantation as postremission therapy. The French Group on Therapy for Adult Acute Lymphoblastic Leukemia. J Clin Oncol 1993; 11: 1990–2001.

    Article  CAS  PubMed  Google Scholar 

  6. Thiebaut A, Vernant JP, Degos L, Huguet FR, Reiffers J, Sebban C et al. Adult acute lymphocytic leukemia study testing chemotherapy and autologous and allogeneic transplantation. A follow-up report of the French protocol LALA-87. Hem/Oncol Clinics No Am 2000; 14: 1353–1365.

    Article  CAS  Google Scholar 

  7. Thomas X, Boiron JM, Huguet F, Dombret H, Bradstock K, Vey N et al. Outcome of treatment in adults with acute lymphoblastic leukemia: analysis of the LALA-94 trial. J Clin Oncol 2004; 22: 4075–4086.

    Article  CAS  PubMed  Google Scholar 

  8. Dombret H, Gabert J, Boiron JM, Rigal-Huguet F, Blaise D, Thomas X, et al., Groupe d’Etude et de Traitement de la Leucemie Aigue Lymphoblastique de l’Adulte (GET-LALA Group. Outcome of treatment in adults with Philadelphia chromosome-positive acute lymphoblastic leukemia--results of the prospective multicenter LALA-94 trial. Blood 2002; 100: 2357–2366.

    Article  CAS  PubMed  Google Scholar 

  9. Sebban C, Lepage E, Vernant JP, Gluckman E, Attal M, Reiffers J et al. Allogeneic bone marrow transplantation in adult acute lymphoblastic leukemia in first complete remission: a comparative study. French Group of Therapy of Adult Acute Lymphoblastic Leukemia. J Clin Oncol 1994; 12: 2580–2587.

    Article  CAS  PubMed  Google Scholar 

  10. Rowe JM, Buck G, Fielding A, Tallman MS, Burnett AK, Chopra R et al. In adults with standard-risk acute lymphoblastic leukemia the greatest benefit is achieved from an allogeneic transplant in first complete remission and an autologous transplant is less effective than conventional consolidation/maintenance chemotherapy: Final results of the International ALL Trial (MRC UKALL XII / ECOG E2993). abstract 1467 Blood 2006; 108: 5a.

    Article  Google Scholar 

  11. Horowitz MM, Messerer D, Hoelzer D, Gale RP, Neiss A, Atkinson K et al. Chemotherapy compared with bone marrow transplantation for adults with acute lymphoblastic leukemia in first remission. Ann Intern Med 1991; 115: 13–18.

    Article  CAS  PubMed  Google Scholar 

  12. Zhang MJ, Hoelzer D, Horowitz MM, Gale RP, Messerer D, Klein JP et al. Long-term follow-up of adults with acute lymphoblastic leukemia in first remission treated with chemotherapy or bone marrow transplantation. The Acute Lymphoblastic Leukemia Working Committee. Ann Intern Med 1995; 123: 428–431.

    Article  CAS  PubMed  Google Scholar 

  13. Ribera JM, Oriol A, Bethencourt C, Parody R, Hernandez-Rivas JM, Moreno MJ et al. Comparison of intensive chemotherapy, allogeneic or autologous stem cell transplantation as post-remission treatment for adult patients with high-risk acute lymphoblastic leukemia. Results of the PETHEMA ALL-93 trial. Haematologica 2005; 90: 1346–1356.

    CAS  PubMed  Google Scholar 

  14. Ferrando AA, Neuberg DS, Dodge RK, Paietta E, Larson RA, Wiernik PH et al. Prognostic importance of TLX1 (HOX11) oncogene expression in adults with T-cell acute lymphoblastic leukaemia. Lancet 2004; 363: 535–536.

    Article  CAS  PubMed  Google Scholar 

  15. Marks DI, Forman SJ, Blume KG, Pérez WS, Weisdorf DJ, Keating A et al. A comparison of cyclophosphamide and total body irradiation with etoposide and total body irradiation as conditioning regimens for patients undergoing sibling allografting for acute lymphoblastic leukemia in first or second complete remission. Biol Blood Marrow Transplant 2006; 12: 438–453.

    Article  CAS  PubMed  Google Scholar 

  16. Gray R, Wheatley K . How to avoid bias when comparing bone marrow transplantation with chemotherapy. Bone Marrow Transplant 1991; 7 (Suppl 3): 9–12.

    PubMed  Google Scholar 

  17. Messerer D, Neiss A, Aydemir U, Hoelzer D, Arnold R . How can disease-free survival of adult ALL patients with or without transplants be compared? Onkologie 1991; 14: 53–55.

    CAS  PubMed  Google Scholar 

  18. Gupta V, Yi QL, Brandwein J, Minden MD, Schuh AC, Wells RA et al. The role of allogeneic bone marrow transplantation in adult patients below the age of 55 years with acute lymphoblastic leukemia in first complete remission: a donor vs no donor comparison. Bone Marrow Transplant 2004; 33: 397–404.

    Article  CAS  PubMed  Google Scholar 

  19. Ringden O, Labopin M, Bacigalupo A, Arcese W, Schaefer UW, Willemze R et al. Transplantation of peripheral blood stem cells as compared with bone marrow from HLA-identical siblings in adult patients with acute myeloid leukemia and acute lymphoblastic leukemia. J Clin Oncol 2002; 20: 4655–4664.

    Article  CAS  PubMed  Google Scholar 

  20. Lazarus HM, Luger S . Which patients with adult acute lymphoblastic leukemia should undergo a hematopoietic stem cell transplantation? Case-based discussion. Hematology Am Soc Hematol Educ Program 2007; 2007: 444–452.

    Article  Google Scholar 

  21. Yanada M, Matsuo K, Suzuki T, Naoe T . Allogeneic hematopoietic stem cell transplantation as part of postremission therapy improves survival for adult patients with high-risk acute lymphoblastic leukemia. A metaanalysis. Cancer 2007; 106: 2657–2663.

    Article  Google Scholar 

  22. Barrett AJ, Horowitz MM, Ash RC, Atkinson K, Gale RP, Goldman JM et al. Bone marrow transplantation for Philadelphia chromosome-positive acute lymphoblastic leukemia. Blood 1992; 79: 3067–3070.

    CAS  PubMed  Google Scholar 

  23. Snyder DS, Nademanee AP, O’Donnell MR, Parker PM, Stein AS, Margolin K et al. Long-term follow-up of 23 patients with Philadelphia chromosome-positive acute lymphoblastic leukemia treated with allogeneic bone marrow transplant in first complete remission. Leukemia 1999; 13: 2053–2058.

    Article  CAS  PubMed  Google Scholar 

  24. Thomas DA . Philadelphia chromosome-positive acute lymphocytic leukemia: a new era of challenges. Hematology. Am Soc Hematol Educ Prog 2007; 2007: 435–443.

    Article  Google Scholar 

  25. Stirewalt DL, Guthrie KA, Beppu L, Bryant EM, Doney K, Golley T et al. Predictors of relapse and overall survival in Philadelphia chromosome-positive acute lymphoblastic leukemia after transplantation. Biol Blood Marrow Transplant 2003; 9: 206–212.

    Article  PubMed  Google Scholar 

  26. Yanada M, Takeuchi J, Sugiura I, Akiyama H, Usui N, Yagasaki F et al. High complete remission rate and promising outcome by combination of imatinib and chemotherapy for newly diagnosed BCR-ABL positive acute lymphoblastic leukemia: a phase II study by the Japan Adult Leukemia Study Group. J Clin Oncol 2006; 24: 460–466.

    Article  CAS  PubMed  Google Scholar 

  27. Wetzler M, Stock W, Donohue KA, Owzar K, Sher DA, Hoke EE et al. Autologous Stem Cell Transplantation (SCT) Following Sequential Chemotherapy and Imatinib for Adults with Newly Diagnosed Philadelphia Chromosome Positive Acute Lymphoblastic Leukemia (Ph+ ALL)—CALGB study 10001. Blood 2007; 110: 2869 (abstract).

  28. Gorin NC . Autologous stem cell transplantation in acute lymphocytic leukemia. Stem Cells 2002; 20: 3–10.

    Article  CAS  PubMed  Google Scholar 

  29. Egerer G, Goldschmidt H, Zoz M, Ho AD . Autologous bone marrow transplantation in adult patients with acute lymphoblastic leukemia. Leuk Lymphoma 2003; 44: 9–14.

    Article  CAS  PubMed  Google Scholar 

  30. Mato AR, Luger SM . Autologous stem cell transplant in ALL: who should we be transplanting in first remission? Bone Marrow Transplant 2006; 37: 989–995.

    Article  CAS  PubMed  Google Scholar 

  31. Kiehl MG, Kraut L, Schwerdtfeger R, Hertenstein B, Remberger M, Kroeger N et al. Outcome of allogeneic hematopoietic stem cell transplantation in adult patients with acute lymphoblastic leukemia: no difference in related compared with unrelated transplant in first complete remission. J Clin Oncol 2004; 22: 2816–2825.

    Article  PubMed  Google Scholar 

  32. Dahlke J, Kroger N, Zabelina T, Ayuk F, Fehse N, Wolschke C et al. Comparable results in patients with acute lymphoblastic leukemia after related and unrelated stem cell transplantation. Bone Marrow Transplant 2006; 37: 155–163.

    Article  CAS  PubMed  Google Scholar 

  33. Marks DI, Aversa F, Laxarus HM . Alternative donor transplants for adult acute lymphoblastic leukaemia: a comparison of the three major options. Bone Marrow Transplant 2006; 38: 467–475.

    Article  CAS  PubMed  Google Scholar 

  34. Bruggemann M, Raff T, Flohr T, Gokbuget N, Nakao M, Droese J, et al., German Multicenter Study Group for Adult Acute Lymphoblastic Leukemia. Clinical significance of minimal residual disease quantification in adult patients with standard-risk acute lymphoblastic leukemia. Blood 2006; 107: 1116–1123.

    Article  PubMed  Google Scholar 

  35. Foroni L, Mitchell W, Rai LJ, Richards S, Fielding A, Goldstone AH . The value of molecular monitoring for residual disease (MRD) in early morphological remitters among adults diagnosed with B-cell ALL and treated according to the MRC UKALL12 Protocol. Blood 2005; 106 (Suppl 1), abstract 1467.

  36. Stein A, O’Donnell M, Snyder D, Parker P, Nademanee A, Falk P et al. Reduced-intensity stem cell transplantation for high-risk acute lymphoblastic leukemia. Biol Blood Marrow Transplant 2007 (abstract 369).

  37. Niederwieser D, Gentilini C, Hegenbart U, Lange T, Becker C, Wang SY et al. Allogeneic hematopoietic cell transplantation (HCT) following reduced-intensity conditioning in patients with acute leukemias. Critical Rev Oncol/Hematol 2005; 56: 275–281.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Medicine and Cancer Research Center, University of Chicago, Chicago, IL, USA

    R A Larson

Authors
  1. R A Larson
    View author publications

    Search author on:PubMed Google Scholar

Corresponding author

Correspondence to R A Larson.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Larson, R. Allogeneic hematopoietic cell transplantation for adults with ALL. Bone Marrow Transplant 42 (Suppl 1), S18–S24 (2008). https://doi.org/10.1038/bmt.2008.107

Download citation

  • Published:

  • Issue date:

  • DOI: https://doi.org/10.1038/bmt.2008.107

Keywords

Search

Advanced search

Quick links