Bone Marrow Transplantation in Patients with Acute Lymphoblastic Leukemia with Extremely Poor Prognosis: Literature Review and Case Report

BONE MARROW TRANSPLANTATION , , ,

NN Subbotina, AV Popa, IS Dolgopolov, VK Boyarshinov, RI Pimenov, VV Dailidite, GL Mentkevich

N.N. Blokhin Russian Cancer Research Center, 24 Kashirskoye sh., Moscow, Russian Federation, 115478

For correspondence: Natal’ya Nikolaevna Subbotina, PhD, 24 Kashirskoye sh., Moscow, Russian Federation, 115478; Tel.: +7(499)324-45-08; e-mail: natik-23@yandex.ru

For citation: Subbotina N.N., Popa A.V., Dolgopolov I.S., Boyarshinov V.K., Pimenov R.I., Dailidite V.V., Mentkevich G.L. Bone Marrow Transplantation in Patients with Acute Lymphoblastic Leukemia with Extremely Poor Prognosis: Literature Review and Case Report. Klin. Onkogematol. 2015; 8(3): 331-6. (In Russ.)

ABSTRACT

The difference in the survival rate between patients receiving the chemotherapy alone and those receiving the chemotherapy with hematopoietic stem cell transplantation (HSCT) becomes more significant with the increased number of acute lymphoblastic leukemia (ALL) risk factors. Myeloablative conditioning regimens remain a gold standard before HSCT in children and young adults with ALL. The traditional TBI-CPM based conditioning regimen followed by HSCT from related HLA identical donor demonstrates the highest survival rates. The survival rate of patients with ALL relapses after allogeneic HSCT remains low. The second HSCT is the only possible therapeutic option that provides a longer survival rate for not more than 10–15 % of patients. Delayed relapses after the first HSCT and patient’s age less than 10 y.o. are statistically significant factors of a better prognosis. The article describes author’s own experience in the management of an ALL high-risk group patients who have undergone chemotherapy, 3 allogeneic related HSCT with involvement of several donors, as well as an additional transfusion of peripheral blood stem cells obtained from the second HLA matching donor. The patient remains under medical supervision in the N.N. Blokhin Russian Cancer Research Center by the date of composition of this paper (23 months after a haploidentical HSCT).

Keywords: acute lymphoblastic leukemia, extremely poor prognosis, hematopoietic stem cell transplantation, conditioning regimen.

Received: March 3, 2015

Accepted: June 3, 2015

Read in PDF (RUS)pdficon

REFERENCES

  1. Favre C, Foa R, Locatelli F, et al. Hematopoietic stem cell transplantation for children with high-risk acute lymphoblastic leukemia in first complete remission: a report from the AIEOP registry. Haematologica. 2013;98(8):1273–81. doi: 10.3324/haematol.2012.079707.
  2. Silverman LB, Gelber RD, Clavell LA, et al. Improved outcome for children with acute lymphoblastic leukemia: results of Dana-Farber Consortium Protocol 91-01. Blood. 2001;97(5):1211–8. doi: 10.1182/blood.v97.5.1211.
  3. Arico M, Valsecchi MG, Messina C, et al. Improved outcome in high-risk childhood acute lymphoblastic leukemia defined by prednisone poor response treated with double Berlin-Frankfurt-Muenster protocol II. Blood. 2002;100(2):420–6. doi: 10.1182/blood.v100.2.420.
  4. Pui CH, Robison LL, Look AT. Acute lymphoblastic leukaemia. The Lancet. 2008;371(9617):1030–43. doi: 10.1016/s0140-6736(08)60457-2.
  5. Pulte D, Gondos A, Brenner H. Trends in 5-and 10-year survival after diagnosis with childhood hematologic malignancies in the United States 1990–2004. J Natl Cancer Inst. 2008;100(18):1271–3. doi: 10.1093/jnci/djn276.
  6. Burke PW, Douer D. Acute lymphoblastic leukemia in adolescents and young adults. Acta Haematol. 2014;132(3–4):264–73. doi: 10.1159/000360204.
  7. Barry EV, Silverman LB. Acute lymphoblastic leukemia in adolescents and young adults. Curr Hematol Malig Rep. 2008;3(3):161–6. doi: 10.1007/s11899-008-0023-9.
  8. Balduzzi A, Klingebiel T, Peters C, et al. Chemotherapy versus allogeneic transplantation for very-high-risk childhood acute lymphoblastic leukaemia in first complete remission: comparison by genetic randomization in an international prospective study. The Lancet. 2005;366(9486):635–42. doi: 10.1016/s0140-6736(05)66998-x.
  9. Kato M, Horikoshi Y, Okamoto Y, et al. Second allogeneic hematopoietic SCT for relapsed ALL in children. Bone Marrow Transplant. 2012;47(10):1307–11. doi: 10.1038/bmt.2012.29.
  10. Poon LM, Bassett R. Jr, Kebriaei P, et al. Outcomes of second allogeneic hematopoietic stem cell transplantation for patients with acute lymphoblastic leukemia. Bone Marrow Transplant. 2013;48(5):666–70. doi: 10.1038/bmt.2012.195.
  11. Spyridonidis A, Labopin M, Rocha V, et al. Immunotherapy Subcommittee of Acute Leukemia Working Party. Outcomes and prognostic factors of adults with acute lymphoblastic leukemia who relapse after allogeneic hematopoietic cell transplantation. An analysis on behalf of the Acute Leukemia Working Party of EBMT. Leukemia. 2012;26(6):1211–7. doi: 10.1038/leu.2011.351.
  12. Mohty M, Nagler A, Rocha V, et al. Acute Leukemia Working Party of EBMT. Reduced-intensity versus conventional myeloablative conditioning allogeneic stem cell transplantation for patients with acute lymphoblastic leukemia: a retrospective study from the European Group for Blood and Marrow Transplantation. Blood. 2010;116(22):4439–43. doi: 10.1182/blood-2010-02-266551.
  13. Eom KS, Shin SH, Lee S, et al. Comparable long-term outcomes after reduced-intensity conditioning versus myeloablative conditioning allogeneic stem cell transplantation for adult high-risk acute lymphoblastic leukemia in complete remission. Am J Hematol. 2013;88(8):634–41. doi: 10.1002/ajh.23465.
  14. Verneris MR, Eapen M, Davies SM, et al. Reduced-Intensity Conditioning Regimens for Allogeneic Transplantation in Children with Acute Lymphoblastic Leukemia. Biol Blood Marrow Transplant. 2010;16(9):1237–44. doi: 10.1016/j.bbmt.2010.03.009.
  15. Bunin N, Cnaan A, Simms S, et al. Randomized trial of busulfan vs total body irradiation containing conditioning regimens for children with acute lymphoblastic leukemia: a Pediatric Blood and Marrow Transplant Consortium study. Bone Marrow Transplant. 2003;32(6):543–8. doi: 10.1038/sj.bmt.1704198.
  16. Davies SM, Ramsay NK, Horowitz MM, et al. Comparison of preparative regimens in transplants for children with acute lymphoblastic leukemia. J Clin Oncol. 2000;18(2):340–7.
  17. Blaise D, Maraninchi D, Archimbaud E, et al. Allogeneic bone marrow transplantation for acute myeloid leukemia in first remission: A randomized trial of a busulfan-cytoxan versus cytoxan-total body irradiation as preparative regimen. A report from the Groupe d’Etudes de la Greffe de Moelle Osseuse. Blood. 1992;79:2578–82.
  18. Dusenbery KE, Daniels KA, McClure JS, et al. Randomized comparison of cyclophosphamide-total body irradiation versus busulfan-cyclophosphamide conditioning in autologous bone marrow transplantation for acute myeloid leukemia. Int J Radiat Oncol Biol Phys. 1995;31(1):119–28. doi: 10.1016/0360-3016(94)00335-i.
  19. Ringden O, Ruutu T, Remberger M, et al. A randomized trial comparing busulfan with total body irradiation as conditioning in allogeneic marrow transplant recipients with leukemia: A report from the Nordic Bone Marrow Transplantation Group. Blood. 1994;83(9):2723–30.
  20. Ringden O, Labopin M, Tura S, et al. A comparison of busulfan versus total body irradiation combined with cyclophosphamide as conditioning for autograft or allograft bone marrow transplantation in patients with acute leukemia. Br J Haematol. 1996;93(3):637–45. doi: 10.1046/j.1365-2141.1996.d01-1681.x.
  21. Rozman C, Carreras E, Qian C, et al. Risk factors for hepatic veno-occlusive disease following HLA-identical sibling bone marrow transplantation for leukemia. Bone Marrow Transplant. 1996;17(1):75–80.
  22. Bhatia S, Ramsay NK, Neglia JP, et al. Malignant neoplasms following bone marrow transplantation. Blood. 1996;87(9):3633–9.
  23. Deeg HJ, Gluckman E, Storb R, et al. Malignancies after marrow transplantation for aplastic anemia and Fanconi anemia: a joint Seattle and Paris analysis of results in 700 patients. Blood. 1996;87(1):386–92.
  24. Chou RH, Wong GB, Wara WM, et al. Toxicities of total-body irradiation for pediatric bone marrow transplantation. Int J Radiat Oncol Biol Phys. 1996;34(4):843–51.