{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T03:08:26Z","timestamp":1768273706464,"version":"3.49.0"},"reference-count":28,"publisher":"American Society of Hematology","issue":"2","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2008,7,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>We report the retrospective outcomes of unrelated donor (URD) transplants in 169 patients with acute lymphoblastic leukemia (ALL) in first complete remission (CR1) who received transplants between 1995 and 2004. Median age was 33 years (range, 16-59 years). A total of 50% had a white blood cell count (WBC) more than 30 \u00d7 109\/L, 18% extramedullary disease, 42% achieved CR more than 8 weeks from diagnosis, 25% had adverse cytogenetics, and 19% had T-cell leukemia. A total of 41% were HLA well-matched, 41% partially matched with their donors, and 18% were HLA-mismatched. At 54-month median follow-up, incidences of acute grade 2-IV, III to IV, and chronic graft-versus-host disease were 50%, 25%, and 43%, respectively. Five-year treatment-related mortality (TRM), relapse, and overall survival were 42%, 20%, and 39%, respectively. In multivariate analyses, TRM was significantly higher with HLA-mismatched donors and T-cell depletion. Relapse risk was higher if the diagnostic WBC was more than 100 \u00d7 109\/L. Factors associated with poorer survival included WBC more than 100 \u00d7 109\/L, more than 8 weeks to CR1, cytomegalovirus seropositivity, HLA mismatching, and T-cell depletion. Nearly 40% of adults with ALL in CR1 survive 5 years after URD transplantation. Relapse risks were modest; TRM is the major cause of treatment failure. Selecting closely HLA-matched URD and reducing TRM should improve results.<\/jats:p>","DOI":"10.1182\/blood-2007-12-128918","type":"journal-article","created":{"date-parts":[[2008,4,9]],"date-time":"2008-04-09T01:30:23Z","timestamp":1207704623000},"page":"426-434","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":71,"title":["Unrelated donor transplants in adults with Philadelphia-negative acute lymphoblastic leukemia in first complete remission"],"prefix":"10.1182","volume":"112","author":[{"given":"David I.","family":"Marks","sequence":"first","affiliation":[{"name":"Adult Blood and Marrow Transplantation (BMT) Unit, United Bristol Healthcare Trust, Bristol, United Kingdom;"}]},{"given":"Waleska S.","family":"P\u00e9rez","sequence":"additional","affiliation":[{"name":"Center for International BMT Research, Medical College of Wisconsin, Milwaukee;"}]},{"given":"Wensheng","family":"He","sequence":"additional","affiliation":[{"name":"Center for International BMT Research, Medical College of Wisconsin, Milwaukee;"}]},{"given":"Mei-Jie","family":"Zhang","sequence":"additional","affiliation":[{"name":"Center for International BMT Research, Medical College of Wisconsin, Milwaukee;"}]},{"given":"Michael R.","family":"Bishop","sequence":"additional","affiliation":[{"name":"National Cancer Institute, Bethesda, MD;"}]},{"given":"Brian J.","family":"Bolwell","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Foundation, OH;"}]},{"given":"Christopher N.","family":"Bredeson","sequence":"additional","affiliation":[{"name":"Medical College of Wisconsin, Milwaukee;"}]},{"given":"Edward A.","family":"Copelan","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Foundation, OH;"}]},{"given":"Robert Peter","family":"Gale","sequence":"additional","affiliation":[{"name":"Center for Advanced Studies in Leukemia, Los Angeles, CA;"}]},{"given":"Vikas","family":"Gupta","sequence":"additional","affiliation":[{"name":"Princess Margaret Hospital, Toronto, ON;"}]},{"given":"Gregory A.","family":"Hale","sequence":"additional","affiliation":[{"name":"St Jude Children's Research Hospital, Memphis, TN;"}]},{"given":"Luis M.","family":"Isola","sequence":"additional","affiliation":[{"name":"Mount Sinai Hospital, New York, NY;"}]},{"given":"Ann A.","family":"Jakubowski","sequence":"additional","affiliation":[{"name":"Memorial Sloan-Kettering Cancer Center, New York, NY;"}]},{"given":"Armand","family":"Keating","sequence":"additional","affiliation":[{"name":"Princess Margaret Hospital, Toronto, ON;"}]},{"given":"Thomas R.","family":"Klumpp","sequence":"additional","affiliation":[{"name":"Fox Chase-Temple BMT Program, Philadelphia, PA;"}]},{"given":"Hillard M.","family":"Lazarus","sequence":"additional","affiliation":[{"name":"University Hospitals of Cleveland, OH;"}]},{"given":"Jane L.","family":"Liesveld","sequence":"additional","affiliation":[{"name":"University of Rochester Medical Center, NY;"}]},{"given":"Richard T.","family":"Maziarz","sequence":"additional","affiliation":[{"name":"Oregon Health and Science University, Portland;"}]},{"given":"Philip L.","family":"McCarthy","sequence":"additional","affiliation":[{"name":"Roswell Park Cancer Institute, Buffalo, NY;"}]},{"given":"Mitchell","family":"Sabloff","sequence":"additional","affiliation":[{"name":"Ottawa Hospital, Ottawa, ON;"}]},{"given":"Gary","family":"Schiller","sequence":"additional","affiliation":[{"name":"University of California, Los Angeles;"}]},{"given":"Jorge","family":"Sierra","sequence":"additional","affiliation":[{"name":"Hospital Santa Creu Sant Pau, Barcelona, Spain;"}]},{"given":"Martin S.","family":"Tallman","sequence":"additional","affiliation":[{"name":"Northwestern Memorial Hospital, Chicago, IL;"}]},{"given":"Edmund K.","family":"Waller","sequence":"additional","affiliation":[{"name":"Emory University Hospital, Atlanta, GA;"}]},{"given":"Peter H.","family":"Wiernik","sequence":"additional","affiliation":[{"name":"Our Lady of Mercy Medical Center, Bronx, NY; and"}]},{"given":"Daniel J.","family":"Weisdorf","sequence":"additional","affiliation":[{"name":"University of Minnesota, Minneapolis"}]}],"member":"234","reference":[{"key":"2019111713210860000_B1","doi-asserted-by":"crossref","first-page":"1827","DOI":"10.1182\/blood-2007-10-116582","article-title":"In adults with standard-risk acute lymphoblastic leukemia (ALL) the greatest benefit is achieved from an allogeneic transplant in first complete remission (CR) and an autologous transplant is less effective than conventional consolidation\/maintenance chemotherapy: final results of the International ALL Trial (MRC UKALL XII \/ ECOG E2993).","volume":"111","author":"Rowe","year":"2008","journal-title":"Blood"},{"key":"2019111713210860000_B2","doi-asserted-by":"crossref","first-page":"3760","DOI":"10.1182\/blood-2005-04-1623","article-title":"Induction therapy for adults with acute lymphoblastic leukemia: results of more than 1500 patients from the international ALL trial: MRC UKALL XII\/ECOG E2993.","volume":"106","author":"Rowe","year":"2005","journal-title":"Blood"},{"key":"2019111713210860000_B3","doi-asserted-by":"crossref","first-page":"1619","DOI":"10.1182\/blood.V86.4.1619.bloodjournal8641619","article-title":"Consolidation treatment of adult acute lymphoblastic leukemia: a prospective, randomized trial comparing allogeneic versus autologous bone marrow transplantation and testing the impact of recombinant interleukin-2 after autologous bone marrow transplantation and BGMT Group.","volume":"86","author":"Attal","year":"1995","journal-title":"Blood"},{"key":"2019111713210860000_B4","doi-asserted-by":"crossref","first-page":"3028","DOI":"10.1182\/blood-2003-10-3560","article-title":"Better outcome of adult acute lymphoblastic leukemia after early genoidentical allogeneic bone marrow transplantation (BMT) than after late high-dose therapy and autologous BMT: a GOELAMS trial.","volume":"104","author":"Hunault","year":"2004","journal-title":"Blood"},{"key":"2019111713210860000_B5","doi-asserted-by":"crossref","first-page":"2657","DOI":"10.1002\/cncr.21932","article-title":"Allogeneic hematopoietic stem cell transplantation as part of postremission therapy improves survival for adult patients with high-risk acute lymphoblastic leukemia: a metaanalysis.","volume":"106","author":"Yanada","year":"2006","journal-title":"Cancer"},{"key":"2019111713210860000_B6","doi-asserted-by":"crossref","first-page":"3189","DOI":"10.1182\/blood-2006-10-051912","article-title":"Karyotype is an independent prognostic factor in adult acute lymphoblastic leukemia (ALL): analysis of cytogenetic data from patients treated on the Medical Research Council (MRC) UKALLXII\/Eastern Cooperative Oncology Group (ECOG) 2993 trial.","volume":"109","author":"Moorman","year":"2007","journal-title":"Blood"},{"key":"2019111713210860000_B7","doi-asserted-by":"crossref","first-page":"1116","DOI":"10.1182\/blood-2005-07-2708","article-title":"Clinical significance of minimal residual disease quantification in adult patients with standard-risk acute lymphoblastic leukemia.","volume":"107","author":"Bruggemann","year":"2006","journal-title":"Blood"},{"key":"2019111713210860000_B8","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1038\/sj.bmt.1705221","article-title":"Comparable results in patients with acute lymphoblastic leukemia after related and unrelated stem cell transplantation.","volume":"37","author":"Dahlke","year":"2006","journal-title":"Bone Marrow Transplant"},{"key":"2019111713210860000_B9","doi-asserted-by":"crossref","first-page":"2816","DOI":"10.1200\/JCO.2004.07.130","article-title":"Outcome of allogeneic hematopoietic stem-cell transplantation in adult patients with acute lymphoblastic leukemia: no difference in related compared with unrelated transplant in first complete remission.","volume":"22","author":"Kiehl","year":"2004","journal-title":"J Clin Oncol"},{"key":"2019111713210860000_B10","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1053\/beha.2001.0173","article-title":"Allogeneic stem cell transplantation for leukaemia using unrelated donors.","volume":"14","author":"Marks","year":"2001","journal-title":"Best Pract Res Clin Haematol"},{"key":"2019111713210860000_B11","doi-asserted-by":"crossref","first-page":"2236","DOI":"10.1182\/blood.V94.7.2236.419k04_2236_2246","article-title":"Children with acute lymphoblastic leukemia who receive T-cell-depleted HLA mismatched marrow allografts from unrelated donors have an increased incidence of primary graft failure but a similar overall transplant outcome.","volume":"94","author":"Green","year":"1999","journal-title":"Blood"},{"key":"2019111713210860000_B12","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1200\/JCO.1998.16.3.931","article-title":"Unrelated donor bone marrow transplantation for children and adolescents with Philadelphia-positive acute lymphoblastic leukemia.","volume":"16","author":"Marks","year":"1998","journal-title":"J Clin Oncol"},{"key":"2019111713210860000_B13","doi-asserted-by":"crossref","first-page":"22a","DOI":"10.1182\/blood.V110.11.45.45","article-title":"Classification of HLA-matching for retrospective analysis of unrelated donor transplantation: revised definitions to predict survival [abstract].","volume":"110","author":"Weisdorf","year":"2007","journal-title":"Blood"},{"key":"2019111713210860000_B14","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1002\/(SICI)1097-0258(19990330)18:6<695::AID-SIM60>3.0.CO;2-O","article-title":"Estimation of failure probabilities in the presence of competing risks: new representations of old estimators.","volume":"18","author":"Gooley","year":"1999","journal-title":"Stat Med"},{"key":"2019111713210860000_B15","article-title":"Survival Analysis: Techniques of Censored and Truncated Data","author":"Klein","year":"2003","edition":"2nd ed"},{"key":"2019111713210860000_B16","doi-asserted-by":"crossref","first-page":"55a","DOI":"10.1182\/blood.V108.11.172.172","article-title":"Single or multiple HLA-A, B, C or DRB1 mismatches limit success of unrelated donor bone marrow transplantation [abstract]","volume":"108","author":"Lee","year":"2006","journal-title":"Blood"},{"key":"2019111713210860000_B17","doi-asserted-by":"crossref","first-page":"944","DOI":"10.1182\/blood-2006-05-018192","article-title":"Outcome of 609 adults after relapse of acute lymphoblastic leukemia (ALL): an MRC UKALL12\/ECOG 2993 study.","volume":"109","author":"Fielding","year":"2007","journal-title":"Blood"},{"key":"2019111713210860000_B18","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1016\/j.bbmt.2005.12.029","article-title":"A comparison of cyclophosphamide and total body irradiation with etoposide and total body irradiation as conditioning regimens for patients undergoing sibling allografting for acute lymphoblastic leukemia in first or second complete remission.","volume":"12","author":"Marks","year":"2006","journal-title":"Biol Blood Marrow Transplant"},{"key":"2019111713210860000_B19","doi-asserted-by":"crossref","first-page":"1572","DOI":"10.1182\/blood.V97.6.1572","article-title":"Unrelated marrow transplantation for adult patients with poor-risk acute lymphoblastic leukemia: strong graft-versus-leukemia effect and risk factors determining outcome.","volume":"97","author":"Cornelissen","year":"2001","journal-title":"Blood"},{"key":"2019111713210860000_B20","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1038\/sj.bmt.1701064","article-title":"Graft-versus-leukemia effects in T lineage and B lineage acute lymphoblastic leukemia.","volume":"21","author":"Passweg","year":"1998","journal-title":"Bone Marrow Transplant"},{"key":"2019111713210860000_B21","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1182\/blood-2006-10-043299","article-title":"Impact of cytogenetics on outcome of matched unrelated donor hematopoietic stem cell transplantation for acute myeloid leukemia in first or second complete remission.","volume":"110","author":"Tallman","year":"2007","journal-title":"Blood"},{"key":"2019111713210860000_B22","first-page":"555","article-title":"Allogeneic hematopoietic stem cell transplantation with reduced-intensity conditioning in acute lymphoblastic leukemia: a feasibility study.","volume":"88","author":"Martino","year":"2003","journal-title":"Haematologica"},{"key":"2019111713210860000_B23","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1038\/sj.bmt.1705123","article-title":"Survival after reduced-intensity conditioning is not inferior to standard high-dose conditioning before allogeneic haematopoietic cell transplantation in acute leukaemias.","volume":"36","author":"Massenkeil","year":"2005","journal-title":"Bone Marrow Transplant"},{"key":"2019111713210860000_B24","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1038\/sj.bmt.1704776","article-title":"Reduced-intensity stem-cell transplantation for adult acute lymphoblastic leukemia: a retrospective study of 33 patients.","volume":"35","author":"Hamaki","year":"2005","journal-title":"Bone Marrow Transplant"},{"key":"2019111713210860000_B25","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/j.bbmt.2006.12.374","article-title":"Reduced-intensity stem cell transplantation for high-risk acute lymphoblastic leukemia [abstract]","volume":"13","author":"Stein","year":"2007","journal-title":"Biol Blood Marrow Transplant"},{"key":"2019111713210860000_B26","first-page":"92a","article-title":"Outcomes of unrelated cord blood and haploidentical stem cell transplantation in adults with acute leukaemia [abstract]","volume":"106","author":"Rocha","year":"2005","journal-title":"Blood"},{"key":"2019111713210860000_B27","doi-asserted-by":"crossref","first-page":"584a","DOI":"10.1182\/blood.V106.11.2064.2064","article-title":"Allogeneic hematopoietic stem cell transplantation (HSCT) in the treatment of acute lymphocytic leukemia (ALL) in 126 adults: impact of donor source on leukemia free survival [abstract]","volume":"106","author":"Kumar","year":"2005","journal-title":"Blood"},{"key":"2019111713210860000_B28","doi-asserted-by":"crossref","first-page":"5695","DOI":"10.1200\/JCO.2006.08.0952","article-title":"Allogeneic marrow stem-cell transplantation from human leukocyte antigen-identical siblings versus human leukocyte antigen-allelic-matched unrelated donors (10\/10) in patients with standard-risk hematologic malignancy: a prospective study from the French Society of Bone Marrow Transplantation and Cell Therapy.","volume":"24","author":"Yakoub-Agha","year":"2006","journal-title":"J Clin Oncol"}],"container-title":["Blood"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/ashpublications.org\/blood\/article-pdf\/112\/2\/426\/1300321\/zh801408000426.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/ashpublications.org\/blood\/article-pdf\/112\/2\/426\/1300321\/zh801408000426.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,11,17]],"date-time":"2019-11-17T18:21:19Z","timestamp":1574014879000},"score":1,"resource":{"primary":{"URL":"https:\/\/ashpublications.org\/blood\/article\/112\/2\/426\/24290\/Unrelated-donor-transplants-in-adults-with"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,7,15]]},"references-count":28,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2008,7,15]]}},"URL":"https:\/\/doi.org\/10.1182\/blood-2007-12-128918","relation":{},"ISSN":["0006-4971","1528-0020"],"issn-type":[{"value":"0006-4971","type":"print"},{"value":"1528-0020","type":"electronic"}],"subject":[],"published":{"date-parts":[[2008,7,15]]}}}