International Journal of Hematology

, 94:291

Sequential chemotherapy and myeloablative allogeneic hematopoietic stem cell transplantation for refractory acute lymphoblastic leukemia

Authors

    • Stem Cell Transplantation CenterHokkaido University Hospital
    • Third Department of Internal Medicine, Graduate School of MedicineUniversity of Toyama
  • Takeshi Kondo
    • Stem Cell Transplantation CenterHokkaido University Hospital
  • Junichi Sugita
    • Stem Cell Transplantation CenterHokkaido University Hospital
  • Akio Shigematsu
    • Stem Cell Transplantation CenterHokkaido University Hospital
  • Souichi Shiratori
    • Stem Cell Transplantation CenterHokkaido University Hospital
  • Kentaro Wakasa
    • Stem Cell Transplantation CenterHokkaido University Hospital
  • Atsushi Yasumoto
    • Stem Cell Transplantation CenterHokkaido University Hospital
  • Makoto Ibata
    • Stem Cell Transplantation CenterHokkaido University Hospital
  • Yusuke Shono
    • Stem Cell Transplantation CenterHokkaido University Hospital
  • Misato Kikuchi
    • Stem Cell Transplantation CenterHokkaido University Hospital
  • Hideki Goto
    • Stem Cell Transplantation CenterHokkaido University Hospital
  • Yukari Takeda
    • Stem Cell Transplantation CenterHokkaido University Hospital
  • Mutsumi Takahata
    • Stem Cell Transplantation CenterHokkaido University Hospital
  • Naoko Kato
    • Stem Cell Transplantation CenterHokkaido University Hospital
  • Mitsufumi Nishio
    • Stem Cell Transplantation CenterHokkaido University Hospital
  • Shuichi Ota
    • Stem Cell Transplantation CenterHokkaido University Hospital
  • Junji Tanaka
    • Stem Cell Transplantation CenterHokkaido University Hospital
  • Masahiro Imamura
    • Stem Cell Transplantation CenterHokkaido University Hospital
Case Report

DOI: 10.1007/s12185-011-0919-3

Cite this article as:
Arita, K., Kondo, T., Sugita, J. et al. Int J Hematol (2011) 94: 291. doi:10.1007/s12185-011-0919-3

Abstract

The prognosis of patients receiving allogeneic hematopoietic stem cell transplantation (HSCT) for refractory acute lymphoblastic leukemia (ALL) is very poor. To improve survival rates, we attempted to intensify the conditioning regimen with daunorubicin, vincristine, prednisolone, medium-dose etoposide, cyclophosphamide, and total body irradiation (DNR/VCR/PSL plus medium-dose VP/CY/TBI). Four patients in relapse or induction failure of B-precursor ALL without other complications underwent allogeneic HSCT. Initially, chemotherapy comprising DNR 60 mg/m2 for 3 days, VCR 1.4 mg/m2 for 1 day, and PSL 60 mg/m2 for 3 days was administered, which was followed by medium-dose VP/CY/TBI; some modifications were made for individual patients. All patients achieved engraftment and complete remission after HSCT. Regimen-related toxicities were tolerable and no patient died within 100 days. Two patients were alive without disease on days 563 and 1,055. The third patient relapsed on day 951, while the fourth died on day 179 without disease. Our results indicate that intensified myeloablative HSCT should be considered for patients with refractory ALL.

Keywords

Acute lymphoblastic leukemiaAllogeneic hematopoietic stem cell transplantationNon-CRRefractory leukemiaInduction failure

Copyright information

© The Japanese Society of Hematology 2011