Hematopoietic Stem Cell Transplantation in Adult Acute Lymphoblastic Leukemia: a Single-Centre Analysis

摘要: The role of autologous or allogeneic hematopoietic stem cell transplantation (HSCT) in ALL is controversial because its adverse risk/benefit ratio, and the main policy to reserve it for high-risk patients. In our Institution, between 1984 2002, 40 patients received an HSCT 39 underwent autografting. conditioning regimen included HD-Ara-C, HD-CTX 10 Gy fractionated TBI. After SCT first CR, four relapsed, leading a 10-year EFS chance 78.3%; other patients, 5 are still CR. autografting there was early death, one secondary AML, death CR six relapses, 44.4%; 6 Even considering limited number slow accrual rate, selection bias cannot be considered sufficient explanation favorable outcome allografting as majority had prognostic factors. It claimed that performed already cured, autografted notably worse outcome, about 80% uncommon finding even standard-risk might inferred timing late intensification, addition rather aggressive regimen, helped minimize leukemic burden, thus favoring expression GVL effect. Conversely, results more advanced disease phases discouraging, due poor quality CRs inefficacy managing large residual disease.