Biology of Blood and Marrow Transplantation
Volume 12, Issue 1 , Pages 1-30 , January 2006

The Role of Cytotoxic Therapy with Hematopoietic Stem Cell Transplantation in the Therapy of Acute Lymphoblastic Leukemia in Adults: An Evidence-based Review

  • Theresa Hahn

      Affiliations

    • Roswell Park Cancer Institute, Buffalo, New York
    • Corresponding Author InformationCorrespondence and reprint requests: Theresa Hahn, PhD, Roswell Park Cancer Institute, Medicine, Elm and Carlton Sts, Buffalo, NY 14263.
  • ,
  • Donna Wall

      Affiliations

    • Texas Transplant Institute, San Antonio, Texas
  • ,
  • Bruce Camitta

      Affiliations

    • Midwest Children’s Center, Medical College of Wisconsin and Children’s Hospital of Wisconsin, Milwaukee, Wisconsin
  • ,
  • Stella Davies

      Affiliations

    • Cincinnati Children’s Hospital and Medical Center, Cincinnati, Ohio
  • ,
  • Hildy Dillon

      Affiliations

    • The Leukemia and Lymphoma Society, White Plains, New York
  • ,
  • Paul Gaynon

      Affiliations

    • Children’s Hospital of Los Angeles, Los Angeles, California
  • ,
  • Richard A. Larson

      Affiliations

    • University of Chicago, Chicago, Illinois
  • ,
  • Susan Parsons

      Affiliations

    • Tufts-New England Medical Center, Boston, Massachusetts
  • ,
  • Jerome Seidenfeld

      Affiliations

    • Blue Cross and Blue Shield Association Technology Evaluation Center, Chicago, Illinois
  • ,
  • Daniel Weisdorf

      Affiliations

    • University of Minnesota, Minneapolis, Minnesota
  • ,
  • Philip L. McCarthy Jr

      Affiliations

    • Roswell Park Cancer Institute, Buffalo, New York

Received 18 October 2005 ,Accepted 19 October 2005.

  • Image Result

    DFS according to the administration of autologous BMT or chemotherapy. BMT: total 96, dead 63; censored, 33. Chemotherapy: total, 95, dead 58; censored, 47. (P=.8). Reprinted with permission [5].

    DFS according to the administration of autologous BMT or chemotherapy. BMT: total 96, dead 63; censored, 33. Chemotherapy: total, 95, dead 58; censored, 47. (P=.8). Reprinted with permission [5].

  • Image Result

    Disease-free survival (DFS) according to second randomization for patients in group 2 (70 patients in the autologous stem-cell transplantation [SCT] arm and 59 patients in the chemotherapy arm). CR, c

    Disease-free survival (DFS) according to second randomization for patients in group 2 (70 patients in the autologous stem-cell transplantation [SCT] arm and 59 patients in the chemotherapy arm). CR, complete remission. Reprinted with permission [7].

  • Image Result
    Disease-free survival (DFS) according to genetic randomization. For this analysis, patients from group 2 (211 patients) and those from group 4 (48 patients) were pooled. The group with a sibling donor

    Disease-free survival (DFS) according to genetic randomization. For this analysis, patients from group 2 (211 patients) and those from group 4 (48 patients) were pooled. The group with a sibling donor comprised 100 patients, whereas that with no sibling donor included 159 patients. CR, complete remission. Reprinted with permission [7].

  • Image Result
    Overall survival of patients with high-risk leukemia according to allocation arm. (Solid line BMT; dashed line control). Reprinted with permission [6].

    Overall survival of patients with high-risk leukemia according to allocation arm. (Solid line BMT; dashed line control). Reprinted with permission [6].

  • Image Result
    Kaplan-Meier estimation of disease-free survival in patients receiving transplantation from a matched related or unrelated donor in first complete remission. Reprinted with permission [56].

    Kaplan-Meier estimation of disease-free survival in patients receiving transplantation from a matched related or unrelated donor in first complete remission. Reprinted with permission [56].

  • Image Result
    Overall survival according to alloBMT and autoBMT in an intent-to-treat analysis. Reprinted with permission [66].

    Overall survival according to alloBMT and autoBMT in an intent-to-treat analysis. Reprinted with permission [66].

  • Image Result
    DFS was significantly superior (P < .001) for patients with an HLA-identical sibling (dashed line) than for patients without an HLA-identical sibling (solid line). Reprinted with permission [67].

    DFS was significantly superior (P < .001) for patients with an HLA-identical sibling (dashed line) than for patients without an HLA-identical sibling (solid line). Reprinted with permission [67].

  • Image Result
    Kaplan-Meier landmark survival estimates (with a 90-day landmark period) for patients eligible for SCT according to the existence of an allogeneic donor (N = 103 patients) (relative risk in the no-don

    Kaplan-Meier landmark survival estimates (with a 90-day landmark period) for patients eligible for SCT according to the existence of an allogeneic donor (N = 103 patients) (relative risk in the no-donor group, 1.71; 95% confidenced interval, 1.09 to 2.68; P = .02 by the log-rank test). Reprinted with permission [8].

 All terms abbreviated in this article are defined in a Glossary of Terms, Appendix A, at the end of the article.

PII: S1083-8791(05)00718-4

doi: 10.1016/j.bbmt.2005.10.018

Biology of Blood and Marrow Transplantation
Volume 12, Issue 1 , Pages 1-30 , January 2006