Allogeneic hematopoietic stem cell transplantation for adult acute lymphoblastic leukemia: Results from a single center,1993-2011

Background: for adult all patients,the indications and appropriate timing of allogeneic hematopoietic stem cell transplantation (ahsct) continue to be debated. the primary aim of this single-institution study was to compare the results of our adult all patients that had been allografted with those reported in the current literature. subjects and methods: this study included 53 consecutive adults with acute lymphoblastic leukemia (all) who underwent allogeneic hematopoietic stem cell transplantation (ahsct) with myeloablative (92%) and reduced-intensity (8%) conditioning between 1993 and 2011. results: mean patient age was 27 years (sd: 8.62) and donor age was 33.7 years (sd: 9.47). fourteen patients were in first remission; 21 in ≥2nd remission,15 in relapse and 3 had primary refractory leukemia. thirty-four,15 and 4 patients received busulfan plus cyclophosphamide,cyclophosphamide/total body irradiation and fludarabine-based regimens,respectively. for graft-versus-host disease (gvhd) prophylaxis,cyclosporine plus methotrexate were used. forty-six donors were related and 7 were unrelated. thirty patients received granulocyte-colony stimulating factor (g-csf) mobilized peripheral blood and 23 received bone marrow as stem cell source. twenty-six patients relapsed at a mean duration of 11.3 months (sd: 19.1). forty-four patients succumbed to their disease after a mean follow-up of 13.6 months (sd: 19.5). the cause of mortality was relapse (n=24; 54.5%) and transplant-related etiologies (n=20; 45.5%). the estimated five year probabilities of overall survival (os) and progression-free survival (pfs) were 37% and 12%,respectively. conclusion: by multivariate analyses,transplantation in first remission was the most important predictor of transplant success. © 2017,tehran university of medical sciences (tums). all rights reserved.