{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T07:01:07Z","timestamp":1763017267174},"reference-count":23,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2013,2,1]],"date-time":"2013-02-01T00:00:00Z","timestamp":1359676800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2013,4]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>To analyse the outcome of adult patients who developed a first relapse of acute lymphoblastic leukaemia (<jats:styled-content style=\"fixed-case\">ALL<\/jats:styled-content>), we collected the clinical data of 332 patients with Philadelphia\u2010chromosome (Ph) negative <jats:styled-content style=\"fixed-case\">ALL<\/jats:styled-content>, aged 16\u201365\u00a0years, who relapsed after first complete remission (<jats:styled-content style=\"fixed-case\">CR<\/jats:styled-content>1) between 1998 and 2008 in 69 institutions all over Japan, including 58 patients who relapsed after allogeneic haematopoietic stem cell transplantation (Allo\u2010<jats:styled-content style=\"fixed-case\">HSCT<\/jats:styled-content>) in <jats:styled-content style=\"fixed-case\">CR<\/jats:styled-content>1. The overall survival (<jats:styled-content style=\"fixed-case\">OS<\/jats:styled-content>) was 43\u00b74% at 1\u00a0year, and 16\u00b73% at 5\u00a0years from relapse in patients who received chemotherapy alone in <jats:styled-content style=\"fixed-case\">CR<\/jats:styled-content>1. Among patients who relapsed after chemotherapy alone in <jats:styled-content style=\"fixed-case\">CR<\/jats:styled-content>1, 123 (52\u00b75%) achieved a second remission (<jats:styled-content style=\"fixed-case\">CR<\/jats:styled-content>2) following salvage chemotherapy, of whom 62 subsequently underwent Allo\u2010<jats:styled-content style=\"fixed-case\">HSCT<\/jats:styled-content> during <jats:styled-content style=\"fixed-case\">CR<\/jats:styled-content>2. Allo\u2010<jats:styled-content style=\"fixed-case\">HSCT<\/jats:styled-content> in <jats:styled-content style=\"fixed-case\">CR<\/jats:styled-content>2 was significantly associated with better <jats:styled-content style=\"fixed-case\">OS<\/jats:styled-content>. Moreover, the type of salvage chemotherapy influenced <jats:styled-content style=\"fixed-case\">OS<\/jats:styled-content> from relapse. A doxorubicin, vincristine, and predonisone\u2010based (Ad<jats:styled-content style=\"fixed-case\">VP<\/jats:styled-content>\u2010type) regimen was related to better <jats:styled-content style=\"fixed-case\">OS<\/jats:styled-content> in patients with longer <jats:styled-content style=\"fixed-case\">CR<\/jats:styled-content>1 (more than 1\u00a0year), but was related to worse <jats:styled-content style=\"fixed-case\">OS<\/jats:styled-content> in patients with shorter <jats:styled-content style=\"fixed-case\">CR<\/jats:styled-content>1. In conclusion, the prognosis of patients with relapsed Ph\u2010negative <jats:styled-content style=\"fixed-case\">ALL<\/jats:styled-content> is poor. Allo\u2010<jats:styled-content style=\"fixed-case\">HSCT<\/jats:styled-content> after a first relapse could improve the prognosis. Selection of the optimal salvage chemotherapy might depend on the duration of <jats:styled-content style=\"fixed-case\">CR<\/jats:styled-content>1.<\/jats:p>","DOI":"10.1111\/bjh.12225","type":"journal-article","created":{"date-parts":[[2013,2,1]],"date-time":"2013-02-01T15:40:25Z","timestamp":1359733225000},"page":"95-103","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Outcome after first relapse in adult patients with Philadelphia chromosome\u2010negative acute lymphoblastic leukaemia"],"prefix":"10.1111","volume":"161","author":[{"given":"Shinichi","family":"Kako","sequence":"first","affiliation":[{"name":"Division of Haematology Saitama Medical Centre Jichi Medical University Saitama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heiwa","family":"Kanamori","sequence":"additional","affiliation":[{"name":"Department of Haematology Kanagawa Cancer Centre Kanagawa 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