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Evidence for a GVL effect following reduced-intensity allo-SCT in ALL: A British Society of Blood and Marrow Transplantation study

Medd, PG; Peniket, AJ; Littlewood, TJ; Pearce, R; Perry, J; Kirkland, KE; Shaw, BE; ... Cook, G; + view all (2013) Evidence for a GVL effect following reduced-intensity allo-SCT in ALL: A British Society of Blood and Marrow Transplantation study. Bone Marrow Transplantation , 48 (7) pp. 982-987. 10.1038/bmt.2012.261.

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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. © 2013 Macmillan Publishers Limited All rights reserved.

Type: Article
Title: Evidence for a GVL effect following reduced-intensity allo-SCT in ALL: A British Society of Blood and Marrow Transplantation study
DOI: 10.1038/bmt.2012.261
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute > Research Department of Haematology
URI: http://discovery.ucl.ac.uk/id/eprint/1405276
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