Faculty Collaboration Database

Evidence for a GVL effect following reduced-intensity allo-SCT in ALL: a British Society of Blood and Marrow Transplantation study. Bone Marrow Transplant 2013 Jul;48(7):982-7

Date

01/16/2013

Pubmed ID

23318533

DOI

10.1038/bmt.2012.261

Scopus ID

2-s2.0-84880222510 (requires institutional sign-in at Scopus site)   10 Citations

Abstract

Myeloablative allo-SCT decreases relapse incidence (RI) in ALL. Reduced intensity conditioning (RIC) may extend allo-SCT to older and less fit patients. Sixty-nine ALL patients reported to the BSBMT underwent fludarabine-based RIC allo-SCT, 38 from unrelated donors (UD). Forty-four patients received alemtuzumab. ALL was in CR in 64 patients (93%). This was a second or third SCT in 23 patients. Two-year OS and PFS were 36% and 32%, respectively. In multivariate analysis male recipients demonstrated better OS and PFS (hazard ratio (HR) = 0.42, P = 0.008 and HR = 0.45, P = 0.012, respectively). Two-year TRM was 29%: higher with younger age (HR = 0.97/year, P = 0.041), female recipient (HR = 2.55, P = 0.049) and increasing grade of acute GVHD (HR = 1.87, P = 0.001). Two-year RI was 38% and was lower in patients with acute and chronic GVHD (HR = 0.62 per increasing grade, P = 0.035 and HR = 0.52, P = 0.025, respectively). Long-term ALL-free survival is achievable following fludarabine-based RIC allo-SCT. The association between GVHD and decreased RI suggests the presence of a GVL effect.

Author List

Medd PG, Peniket AJ, Littlewood TJ, Pearce R, Perry J, Kirkland KE, Shaw BE, Potter MN, Craddock CF, Milligan DW, Fielding AK, Marks DI, Cook G, British Society of Blood and Marrow Transplantation

Author

Bronwen E. Shaw MBChB, PhD Center Director, Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Acute Disease
Adolescent
Adult
Age Factors
Alemtuzumab
Allografts
Antibodies, Monoclonal, Humanized
Antineoplastic Agents
Disease-Free Survival
Female
Graft vs Host Disease
Graft vs Leukemia Effect
Humans
Male
Middle Aged
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Sex Factors
Societies, Medical
Stem Cell Transplantation
Survival Rate
Transplantation Conditioning
United Kingdom
Vidarabine