PMID- 21072046
OWN - NLM
STAT- MEDLINE
DCOM- 20110408
LR  - 20130304
IS  - 1476-5551 (Electronic)
IS  - 0887-6924 (Linking)
VI  - 25
IP  - 2
DP  - 2011 Feb
TI  - A decision analysis of allogeneic hematopoietic stem cell transplantation in 
      adult patients with Philadelphia chromosome-negative acute lymphoblastic leukemia 
      in first remission who have an HLA-matched sibling donor.
PG  - 259-65
LID - 10.1038/leu.2010.260 [doi]
AB  - Clinical studies using genetic randomization cannot accurately answer whether 
      adult patients with Philadelphia chromosome-negative acute lymphoblastic leukemia 
      (ALL) who have a human leukocyte antigen (HLA)-matched sibling should undergo 
      allogeneic hematopoietic stem cell transplantation (HSCT) or chemotherapy in 
      first remission, as, in these studies, patients without a sibling donor undergo 
      alternative donor transplantation or chemotherapy alone after a relapse. 
      Therefore, we performed a decision analysis to identify the optimal strategy in 
      this setting. Transition probabilities and utilities were estimated from 
      prospective studies of the Japan Adult Leukemia Study Group, the database of the 
      Japan Society for Hematopoietic Cell Transplantation and the literature. The 
      primary outcome measure was the 10-year survival probability with or without 
      quality of life (QOL) adjustments. Subgroup analyses were performed according to 
      risk stratification on the basis of white blood cell count and cytogenetics, and 
      according to age stratification. In analyses without QOL adjustments, allogeneic 
      HSCT in first remission was superior in the whole population (48.3 vs 32.6%) and 
      in all subgroups. With QOL adjustments, a similar tendency was conserved (44.9 vs 
      31.7% in the whole population). To improve the probability of long-term survival, 
      allogeneic HSCT in first remission is recommended for patients who have an 
      HLA-matched sibling.
FAU - Kako, S
AU  - Kako S
AD  - Division of Hematology, Saitama Medical Center, Jichi Medical University, 
      Saitama, Japan.
FAU - Morita, S
AU  - Morita S
FAU - Sakamaki, H
AU  - Sakamaki H
FAU - Ogawa, H
AU  - Ogawa H
FAU - Fukuda, T
AU  - Fukuda T
FAU - Takahashi, S
AU  - Takahashi S
FAU - Kanamori, H
AU  - Kanamori H
FAU - Onizuka, M
AU  - Onizuka M
FAU - Iwato, K
AU  - Iwato K
FAU - Suzuki, R
AU  - Suzuki R
FAU - Atsuta, Y
AU  - Atsuta Y
FAU - Kyo, T
AU  - Kyo T
FAU - Sakura, T
AU  - Sakura T
FAU - Jinnai, I
AU  - Jinnai I
FAU - Takeuchi, J
AU  - Takeuchi J
FAU - Miyazaki, Y
AU  - Miyazaki Y
FAU - Miyawaki, S
AU  - Miyawaki S
FAU - Ohnishi, K
AU  - Ohnishi K
FAU - Naoe, T
AU  - Naoe T
FAU - Kanda, Y
AU  - Kanda Y
LA  - eng
PT  - Journal Article
DEP - 20101112
PL  - England
TA  - Leukemia
JT  - Leukemia
JID - 8704895
RN  - 0 (HLA Antigens)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Age Factors
MH  - Cytogenetic Analysis
MH  - Databases, Factual
MH  - *Decision Support Techniques
MH  - Female
MH  - HLA Antigens
MH  - Hematopoietic Stem Cell Transplantation/*methods
MH  - *Histocompatibility
MH  - Humans
MH  - Leukocyte Count
MH  - Male
MH  - Middle Aged
MH  - Philadelphia Chromosome
MH  - Precursor Cell Lymphoblastic Leukemia-Lymphoma/mortality/*therapy
MH  - Probability
MH  - Quality of Life
MH  - Remission Induction
MH  - Risk Assessment
MH  - Siblings
MH  - Survival Rate
MH  - Transplantation, Homologous
MH  - Young Adult
EDAT- 2010/11/13 06:00
MHDA- 2011/04/09 06:00
CRDT- 2010/11/13 06:00
PHST- 2010/11/13 06:00 [entrez]
PHST- 2010/11/13 06:00 [pubmed]
PHST- 2011/04/09 06:00 [medline]
AID - leu2010260 [pii]
AID - 10.1038/leu.2010.260 [doi]
PST - ppublish
SO  - Leukemia. 2011 Feb;25(2):259-65. doi: 10.1038/leu.2010.260. Epub 2010 Nov 12.