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Blood, 1 August 2008, Vol. 112, No. 3, pp. 903-909. Prepublished online as a Blood First Edition Paper on June 2, 2008; DOI 10.1182/blood-2008-03-143115. This Article Full Text Full Text (PDF) All Versions of this Article: blood-2008-03-143115v1 112/3/903    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via CrossRef Google Scholar Articles by Laport, G. G. Articles by Forman, S. J. PubMed PubMed Citation Articles by Laport, G. G. Articles by Forman, S. J. Related Collections Neoplasia Transplantation Free Research Articles Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  TRANSPLANTATION Long-term remission of Philadelphia chromosome–positive acute lymphoblastic leukemia after allogeneic hematopoietic cell transplantation from matched sibling donors: a 20-year experience with the fractionated total body irradiation–etoposide regimen Ginna G. Laport1, Joseph C. Alvarnas2, Joycelynne M. Palmer2, David S. Snyder2, Marilyn L. Slovak2, Athena M. Cherry1, Ruby M. Wong1, Robert S. Negrin1, Karl G. Blume1, and Stephen J. Forman2 1 Division of Blood and Marrow Transplantation and Department of Pathology, Stanford University School of Medicine, CA; and 2 Hematology/Hematopoietic Cell Transplantation, Biostatistics, and Pathology, City of Hope National Medical Center, Duarte, CA Allogeneic hematopoietic cell transplantation (HCT) is the only known curative modality for patients with Philadelphia chromosome–positive acute lymphoblastic leukemia (Ph+ ALL). Sixty-seven patients with HLA-matched sibling donors received fractionated total body irradiation (FTBI) and high-dose VP16, whereas 11 patients received FTBI/VP16/cyclophosphamide, and 1 patient received FTBI/VP16/busulfan. The median age was 36 years. At the time of HCT, 49 patients (62%) were in first complete remission (CR1) and 30 patients (38%) were beyond CR1 (> CR1). The median follow-up was 75 months (range, 14-245 months). The 10-year overall survival for the CR1 and beyond CR1 patients was 54% and 29% (P = .01), respectively, and event-free survival was 48% and 26% (P = .02), respectively. There was no significant difference in relapse incidence (28% vs 41%, P = .28), but nonrelapse mortality was significantly higher in the beyond CR1 patients, (31% vs 54%, P = .03, respectively). By univariate analysis, factors affecting event-free and overall survival were white blood cell count at diagnosis (< 30 x 109/L vs > 30 x 109/L) and disease status (CR1 vs > CR1). The median time to relapse for CR1 and for beyond CR1 patients was 12 months and 9 months, respectively. Our results indicate that FTBI/VP16 with or without cyclophosphamide confers long-term survival in Ph+ ALL patients and that disease status at the time of HCT is an important predictor of outcome. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

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