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Allo -HSCT for ALL

Allo -HSCT for ALL. 林建廷. Cancer 2006;106: 2657–63. EBMT: allo -HSCT in ALL. ECOG 2993. ECOG 2993. All pts. Risk stratification at diagnosis. OS. Standard risk. 55%. High risk. 34%. cHR pts. 25%Ph+. 5%. ECOG 2993. ECOG 2993. What happen if relapse? ECOG2993.

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Allo -HSCT for ALL

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  1. Allo-HSCT for ALL 林建廷

  2. Cancer 2006;106:2657–63

  3. EBMT: allo-HSCT in ALL

  4. ECOG 2993

  5. ECOG 2993 All pts Risk stratification at diagnosis OS Standard risk 55% High risk 34% cHR pts 25%Ph+ 5%

  6. ECOG 2993

  7. ECOG 2993

  8. What happen if relapse? ECOG2993

  9. What happen if relapse? ECOG2993

  10. Therapy in relapse and outcome--ECOG2993

  11. MRD and Standard Risk Adult ALL • Germany GMALL group • rt-PCR method, 105 pts in cHR with MRD(-) at enroll • No high WBC, not pro-B, pre-T, mature T, no poor cyt • Median molecular to clinical relapse:9.5m 5/77 (6%) 17/28 (61%) Blood. 2007;109:910-915

  12. RIST for Adult ALL, from EBMT Haematologica 2008 Feb; 93(2):303-306.

  13. RIST for Adult ALL, from EBMT • Retrospective, 97 pts 2-yr Leukemic-free survival Non-relapse mortality Relapse incidence 40%@2yr for CR1 18%@2yr for CR1 52% 42% 18% Haematologica 2008 Feb; 93(2):303-306.

  14. HCT-Comorbidity Index • HCT-CI is 0, and NRM~20%

  15. PAM Score for Allo-HSCT

  16. PAM score is: • 17 if RIST • 20 if myeloablative (non-TBI) • 24 if myeloablative (TBI 12 Gy)

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