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Allogeneic transplant compared to pediatric-inspired therapy for Philadelphia chromosome-negative adolescent and adult ALL in first complete remission

Bone Marrow Transplantation volume 57, pages 593–597 (2022)Cite this article

Subjects

Abstract

Background

Pediatric-inspired non-transplant regimens for adolescent and adult ALL patients are becoming standard in many institutions. We aimed to compare a cohort of patients receiving a pediatric-inspired protocol to a cohort of patients treated with adult type ALL therapy followed by allografting after achieving CR1.

Method

Eighty-five adolescent and adult ALL patients treated with CALGB 19802 protocol who received MSD transplant in CR1 were retrospectively compared to a matched cohort of 72 adolescent and adult ALL patients treated with a modified version of Children’s Cancer Group (CCG) 1900 protocol.

Results

The five years OS in the allo-HCT cohort was 63.1% compared to 80.2% in the pediatric-inspired chemotherapy arm (P = 0.03). The five years EFS in the allo-HCT arm was 58.8% compared to 61.6% in the pediatric-inspired chemotherapy arm (P = 0.07). The five years DFS in the allo-HCT arm was 58.8% as compared to 71.9% in the pediatric-inspired chemotherapy arm (P = 0.07). The relapse rate in the allo-HCT cohort was 30.58% compared to 21.68% in the pediatric-inspired chemotherapy arm (P = 0.16). The NRM in the allo-HCT cohort was 10.59 as compared to 6.45 in the pediatric-inspired chemotherapy arm (P = 0.3).

Conclusion

For adolescent and adult patients with Ph-negative ALL, pediatric-inspired chemotherapy resulted in higher OS compared to allo-HCT.

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Authors and Affiliations

  1. King Faisal Specialist Hospital and Research Center, KSA, Riyadh, Saudi Arabia

    Alfadil Haroon, Feras Alfraih, Amr Hanbali, Ahmed Kotb, Zakiah Al Somali, Fahad N. Bahkali, Saud Alhayli, Heba Mahmoud Madien, Syed Osman Ahmed, Abdulwahab A. Albabtain, Marwan Shaheen, Naeem Chaudhri, Fahad Alsharif, Alfadel Alshaibani, Ahmad S. Alotaibi, Tusneem Elhassan, Fahad Almohareb, Ali Alahmari, Walid Rasheed, Hazzaa Alzahrani, Mahmoud Aljurf & Riad El Fakih

  2. Clinical Hematology Unit, Department of Internal Medicine, Faculty of Medicine, Zagazig University, Zagazig, 44519, Egypt

    Ahmed Kotb

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  1. Alfadil Haroon
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Contributions

R.E, A.H designed and performed the research. T.E analyzed the data. R. E, A.H wrote the first draft. All the co-authors revised and approved the final manuscript.

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Correspondence to Riad El Fakih.

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Haroon, A., Alfraih, F., Hanbali, A. et al. Allogeneic transplant compared to pediatric-inspired therapy for Philadelphia chromosome-negative adolescent and adult ALL in first complete remission. Bone Marrow Transplant 57, 593–597 (2022). https://doi.org/10.1038/s41409-022-01595-9

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