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Optimal treatment for Philadelphia-negative acute lymphoblastic leukemia in first remission in the era of high-intensity chemotherapy
The optimal treatment for Philadelphia chromosome (Ph)-negative acute lymphoblastic leukemia (ALL) in first complete remission (CR1) has not been established in the high-intensity chemotherapy era. The outcomes of patients with Ph-negative ALL who underwent allogeneic hematopoietic stem cell transpl...
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| Published in: | International journal of hematology 2021-11, Vol.114 (5), p.608-619 |
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| container_end_page | 619 |
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| container_title | International journal of hematology |
| container_volume | 114 |
| creator | Kako, Shinichi Hayakawa, Fumihiko Imai, Kiyotoshi Tanaka, Junji Mizuta, Shuichi Nishiwaki, Satoshi Kanamori, Heiwa Mukae, Junichi Ozawa, Yukiyasu Kondo, Tadakazu Fukuda, Takahiro Ichinohe, Tatsuo Ota, Shuichi Tanaka, Yoshinori Murayama, Tohru Kurahashi, Shingo Sakura, Toru Usui, Noriko Ohtake, Shigeki Kiyoi, Hitoshi Matsumura, Itaru Miyazaki, Yasushi Atsuta, Yoshiko |
| description | The optimal treatment for Philadelphia chromosome (Ph)-negative acute lymphoblastic leukemia (ALL) in first complete remission (CR1) has not been established in the high-intensity chemotherapy era. The outcomes of patients with Ph-negative ALL who underwent allogeneic hematopoietic stem cell transplantation (HSCT) from a human leukocyte antigen-matched related or unrelated donor in CR1 (HSCT-MRD group and HSCT-MUD group) were obtained from a Japanese registry database. Patients aged 16–24 years and 25–65 years were analyzed separately, and their outcomes were compared to those of patients who continued high-intensity chemotherapy in CR1 in studies (202U group and 202O group) by the Japan Adult Leukemia Study Group (JALSG). In the HSCT-MRD group, patients younger than 25 years had lower overall survival (OS) than the 202U group, presumably due to the higher non-relapse mortality (NRM) in the HSCT-MRD group. Patients 25 years and older had similar OS to the 202O group. The lower relapse rate was counterbalanced by higher NRM in the HSCT-MRD group. In the HSCT-MUD group, patients in both age groups had similar OS to their corresponding groups in the JALSG studies. In conclusion, high-intensity chemotherapy may change the role of HSCT for Ph-negative ALL. |
| doi_str_mv | 10.1007/s12185-021-03198-4 |
| format | article |
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The outcomes of patients with Ph-negative ALL who underwent allogeneic hematopoietic stem cell transplantation (HSCT) from a human leukocyte antigen-matched related or unrelated donor in CR1 (HSCT-MRD group and HSCT-MUD group) were obtained from a Japanese registry database. Patients aged 16–24 years and 25–65 years were analyzed separately, and their outcomes were compared to those of patients who continued high-intensity chemotherapy in CR1 in studies (202U group and 202O group) by the Japan Adult Leukemia Study Group (JALSG). In the HSCT-MRD group, patients younger than 25 years had lower overall survival (OS) than the 202U group, presumably due to the higher non-relapse mortality (NRM) in the HSCT-MRD group. Patients 25 years and older had similar OS to the 202O group. The lower relapse rate was counterbalanced by higher NRM in the HSCT-MRD group. In the HSCT-MUD group, patients in both age groups had similar OS to their corresponding groups in the JALSG studies. In conclusion, high-intensity chemotherapy may change the role of HSCT for Ph-negative ALL.</description><identifier>ISSN: 0925-5710</identifier><identifier>EISSN: 1865-3774</identifier><identifier>DOI: 10.1007/s12185-021-03198-4</identifier><identifier>PMID: 34328634</identifier><language>eng</language><publisher>Singapore: Springer Singapore</publisher><subject>Acute lymphoblastic leukemia ; Adult ; Aged ; Aged, 80 and over ; Antigens ; Antineoplastic Combined Chemotherapy Protocols - adverse effects ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Chemotherapy ; Clinical Decision-Making ; Combined Modality Therapy ; Disease Management ; Female ; Hematology ; Hematopoietic Stem Cell Transplantation ; Hematopoietic stem cells ; Histocompatibility antigen HLA ; Histocompatibility Testing ; Humans ; Leukemia ; Leukocytes ; Lymphatic leukemia ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Mud ; Oncology ; Original Article ; Patients ; Philadelphia chromosome ; Precursor Cell Lymphoblastic Leukemia-Lymphoma - diagnosis ; Precursor Cell Lymphoblastic Leukemia-Lymphoma - drug therapy ; Precursor Cell Lymphoblastic Leukemia-Lymphoma - etiology ; Precursor Cell Lymphoblastic Leukemia-Lymphoma - mortality ; Prognosis ; Remission ; Remission (Medicine) ; Remission Induction ; Stem cell transplantation ; Stem cells ; Survival Analysis ; Transplantation ; Transplantation Conditioning ; Transplantation, Homologous ; Treatment Outcome</subject><ispartof>International journal of hematology, 2021-11, Vol.114 (5), p.608-619</ispartof><rights>Japanese Society of Hematology 2021</rights><rights>2021. Japanese Society of Hematology.</rights><rights>Japanese Society of Hematology 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c465t-90ebd957aafc7da36363cea54a77d8e2bd6c2a73f32ade3b2b20ad8499dcbb593</citedby><cites>FETCH-LOGICAL-c465t-90ebd957aafc7da36363cea54a77d8e2bd6c2a73f32ade3b2b20ad8499dcbb593</cites><orcidid>0000-0002-2635-3395</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34328634$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kako, Shinichi</creatorcontrib><creatorcontrib>Hayakawa, Fumihiko</creatorcontrib><creatorcontrib>Imai, Kiyotoshi</creatorcontrib><creatorcontrib>Tanaka, Junji</creatorcontrib><creatorcontrib>Mizuta, Shuichi</creatorcontrib><creatorcontrib>Nishiwaki, Satoshi</creatorcontrib><creatorcontrib>Kanamori, Heiwa</creatorcontrib><creatorcontrib>Mukae, Junichi</creatorcontrib><creatorcontrib>Ozawa, Yukiyasu</creatorcontrib><creatorcontrib>Kondo, Tadakazu</creatorcontrib><creatorcontrib>Fukuda, Takahiro</creatorcontrib><creatorcontrib>Ichinohe, Tatsuo</creatorcontrib><creatorcontrib>Ota, Shuichi</creatorcontrib><creatorcontrib>Tanaka, Yoshinori</creatorcontrib><creatorcontrib>Murayama, Tohru</creatorcontrib><creatorcontrib>Kurahashi, Shingo</creatorcontrib><creatorcontrib>Sakura, Toru</creatorcontrib><creatorcontrib>Usui, Noriko</creatorcontrib><creatorcontrib>Ohtake, Shigeki</creatorcontrib><creatorcontrib>Kiyoi, Hitoshi</creatorcontrib><creatorcontrib>Matsumura, Itaru</creatorcontrib><creatorcontrib>Miyazaki, Yasushi</creatorcontrib><creatorcontrib>Atsuta, Yoshiko</creatorcontrib><title>Optimal treatment for Philadelphia-negative acute lymphoblastic leukemia in first remission in the era of high-intensity chemotherapy</title><title>International journal of hematology</title><addtitle>Int J Hematol</addtitle><addtitle>Int J Hematol</addtitle><description>The optimal treatment for Philadelphia chromosome (Ph)-negative acute lymphoblastic leukemia (ALL) in first complete remission (CR1) has not been established in the high-intensity chemotherapy era. The outcomes of patients with Ph-negative ALL who underwent allogeneic hematopoietic stem cell transplantation (HSCT) from a human leukocyte antigen-matched related or unrelated donor in CR1 (HSCT-MRD group and HSCT-MUD group) were obtained from a Japanese registry database. Patients aged 16–24 years and 25–65 years were analyzed separately, and their outcomes were compared to those of patients who continued high-intensity chemotherapy in CR1 in studies (202U group and 202O group) by the Japan Adult Leukemia Study Group (JALSG). In the HSCT-MRD group, patients younger than 25 years had lower overall survival (OS) than the 202U group, presumably due to the higher non-relapse mortality (NRM) in the HSCT-MRD group. Patients 25 years and older had similar OS to the 202O group. The lower relapse rate was counterbalanced by higher NRM in the HSCT-MRD group. In the HSCT-MUD group, patients in both age groups had similar OS to their corresponding groups in the JALSG studies. In conclusion, high-intensity chemotherapy may change the role of HSCT for Ph-negative ALL.</description><subject>Acute lymphoblastic leukemia</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antigens</subject><subject>Antineoplastic Combined Chemotherapy Protocols - adverse effects</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Chemotherapy</subject><subject>Clinical Decision-Making</subject><subject>Combined Modality Therapy</subject><subject>Disease Management</subject><subject>Female</subject><subject>Hematology</subject><subject>Hematopoietic Stem Cell Transplantation</subject><subject>Hematopoietic stem cells</subject><subject>Histocompatibility antigen HLA</subject><subject>Histocompatibility Testing</subject><subject>Humans</subject><subject>Leukemia</subject><subject>Leukocytes</subject><subject>Lymphatic leukemia</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Mud</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Patients</subject><subject>Philadelphia chromosome</subject><subject>Precursor Cell Lymphoblastic Leukemia-Lymphoma - diagnosis</subject><subject>Precursor Cell Lymphoblastic Leukemia-Lymphoma - drug therapy</subject><subject>Precursor Cell Lymphoblastic Leukemia-Lymphoma - etiology</subject><subject>Precursor Cell Lymphoblastic Leukemia-Lymphoma - mortality</subject><subject>Prognosis</subject><subject>Remission</subject><subject>Remission (Medicine)</subject><subject>Remission Induction</subject><subject>Stem cell transplantation</subject><subject>Stem cells</subject><subject>Survival Analysis</subject><subject>Transplantation</subject><subject>Transplantation Conditioning</subject><subject>Transplantation, Homologous</subject><subject>Treatment Outcome</subject><issn>0925-5710</issn><issn>1865-3774</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kc1u1TAQhS1ERS-FF2CBLLFhY-qfOE6WqCoUqVJZtGtr4kxuXJwfbKfSfQDeG5dbQGKBvLDs-ebM6BxC3gj-QXBuzpOQotGMS8G4Em3DqmdkJ5paM2VM9ZzseCs100bwU_IypXvOheGVeUFOVaVkU6tqR37crNlPEGiOCHnCOdNhifTr6AP0GNbRA5txD9k_IAW3ZaThMK3j0gVI2TsacPuGkwfqZzr4mDKN5ZmSX-bHrzwixQh0Gejo9yPzc8Y5-XygbsRpKeUI6-EVORkgJHz9dJ-Ru0-XtxdX7Prm85eLj9fMVbXOrOXY9a02AIMzPai6HIegKzCmb1B2fe0kGDUoWZZXnewkh76p2rZ3XadbdUbeH3XXuHzfMGVbVnUYAsy4bMlKrY2USmte0Hf_oPfLFueyXaEaXhwuZhZKHikXl5QiDnaNxc54sILbx5DsMSRbQrK_QrJVaXr7JL11E_Z_Wn6nUgB1BFIpzXuMf2f_R_YnXmegWg</recordid><startdate>20211101</startdate><enddate>20211101</enddate><creator>Kako, Shinichi</creator><creator>Hayakawa, Fumihiko</creator><creator>Imai, Kiyotoshi</creator><creator>Tanaka, Junji</creator><creator>Mizuta, Shuichi</creator><creator>Nishiwaki, Satoshi</creator><creator>Kanamori, Heiwa</creator><creator>Mukae, Junichi</creator><creator>Ozawa, Yukiyasu</creator><creator>Kondo, Tadakazu</creator><creator>Fukuda, Takahiro</creator><creator>Ichinohe, Tatsuo</creator><creator>Ota, Shuichi</creator><creator>Tanaka, Yoshinori</creator><creator>Murayama, Tohru</creator><creator>Kurahashi, Shingo</creator><creator>Sakura, Toru</creator><creator>Usui, Noriko</creator><creator>Ohtake, Shigeki</creator><creator>Kiyoi, Hitoshi</creator><creator>Matsumura, Itaru</creator><creator>Miyazaki, Yasushi</creator><creator>Atsuta, Yoshiko</creator><general>Springer Singapore</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7T5</scope><scope>7T7</scope><scope>7TM</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2635-3395</orcidid></search><sort><creationdate>20211101</creationdate><title>Optimal treatment for Philadelphia-negative acute lymphoblastic leukemia in first remission in the era of high-intensity chemotherapy</title><author>Kako, Shinichi ; Hayakawa, Fumihiko ; Imai, Kiyotoshi ; Tanaka, Junji ; Mizuta, Shuichi ; Nishiwaki, Satoshi ; Kanamori, Heiwa ; Mukae, Junichi ; Ozawa, Yukiyasu ; Kondo, Tadakazu ; Fukuda, Takahiro ; Ichinohe, Tatsuo ; Ota, Shuichi ; Tanaka, Yoshinori ; Murayama, Tohru ; Kurahashi, Shingo ; Sakura, Toru ; Usui, Noriko ; Ohtake, Shigeki ; Kiyoi, Hitoshi ; Matsumura, Itaru ; Miyazaki, Yasushi ; Atsuta, Yoshiko</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c465t-90ebd957aafc7da36363cea54a77d8e2bd6c2a73f32ade3b2b20ad8499dcbb593</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Acute lymphoblastic leukemia</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antigens</topic><topic>Antineoplastic Combined Chemotherapy Protocols - adverse effects</topic><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>Chemotherapy</topic><topic>Clinical Decision-Making</topic><topic>Combined Modality Therapy</topic><topic>Disease Management</topic><topic>Female</topic><topic>Hematology</topic><topic>Hematopoietic Stem Cell Transplantation</topic><topic>Hematopoietic stem cells</topic><topic>Histocompatibility antigen HLA</topic><topic>Histocompatibility Testing</topic><topic>Humans</topic><topic>Leukemia</topic><topic>Leukocytes</topic><topic>Lymphatic leukemia</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Mud</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Patients</topic><topic>Philadelphia chromosome</topic><topic>Precursor Cell Lymphoblastic Leukemia-Lymphoma - diagnosis</topic><topic>Precursor Cell Lymphoblastic Leukemia-Lymphoma - drug therapy</topic><topic>Precursor Cell Lymphoblastic Leukemia-Lymphoma - etiology</topic><topic>Precursor Cell Lymphoblastic Leukemia-Lymphoma - mortality</topic><topic>Prognosis</topic><topic>Remission</topic><topic>Remission (Medicine)</topic><topic>Remission Induction</topic><topic>Stem cell transplantation</topic><topic>Stem cells</topic><topic>Survival Analysis</topic><topic>Transplantation</topic><topic>Transplantation Conditioning</topic><topic>Transplantation, Homologous</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kako, Shinichi</creatorcontrib><creatorcontrib>Hayakawa, Fumihiko</creatorcontrib><creatorcontrib>Imai, Kiyotoshi</creatorcontrib><creatorcontrib>Tanaka, Junji</creatorcontrib><creatorcontrib>Mizuta, Shuichi</creatorcontrib><creatorcontrib>Nishiwaki, Satoshi</creatorcontrib><creatorcontrib>Kanamori, Heiwa</creatorcontrib><creatorcontrib>Mukae, Junichi</creatorcontrib><creatorcontrib>Ozawa, Yukiyasu</creatorcontrib><creatorcontrib>Kondo, Tadakazu</creatorcontrib><creatorcontrib>Fukuda, Takahiro</creatorcontrib><creatorcontrib>Ichinohe, Tatsuo</creatorcontrib><creatorcontrib>Ota, Shuichi</creatorcontrib><creatorcontrib>Tanaka, Yoshinori</creatorcontrib><creatorcontrib>Murayama, Tohru</creatorcontrib><creatorcontrib>Kurahashi, Shingo</creatorcontrib><creatorcontrib>Sakura, Toru</creatorcontrib><creatorcontrib>Usui, Noriko</creatorcontrib><creatorcontrib>Ohtake, Shigeki</creatorcontrib><creatorcontrib>Kiyoi, Hitoshi</creatorcontrib><creatorcontrib>Matsumura, Itaru</creatorcontrib><creatorcontrib>Miyazaki, Yasushi</creatorcontrib><creatorcontrib>Atsuta, Yoshiko</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Immunology Abstracts</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Nucleic Acids Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of hematology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kako, Shinichi</au><au>Hayakawa, Fumihiko</au><au>Imai, Kiyotoshi</au><au>Tanaka, Junji</au><au>Mizuta, Shuichi</au><au>Nishiwaki, Satoshi</au><au>Kanamori, Heiwa</au><au>Mukae, Junichi</au><au>Ozawa, Yukiyasu</au><au>Kondo, Tadakazu</au><au>Fukuda, Takahiro</au><au>Ichinohe, Tatsuo</au><au>Ota, Shuichi</au><au>Tanaka, Yoshinori</au><au>Murayama, Tohru</au><au>Kurahashi, Shingo</au><au>Sakura, Toru</au><au>Usui, Noriko</au><au>Ohtake, Shigeki</au><au>Kiyoi, Hitoshi</au><au>Matsumura, Itaru</au><au>Miyazaki, Yasushi</au><au>Atsuta, Yoshiko</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Optimal treatment for Philadelphia-negative acute lymphoblastic leukemia in first remission in the era of high-intensity chemotherapy</atitle><jtitle>International journal of hematology</jtitle><stitle>Int J Hematol</stitle><addtitle>Int J Hematol</addtitle><date>2021-11-01</date><risdate>2021</risdate><volume>114</volume><issue>5</issue><spage>608</spage><epage>619</epage><pages>608-619</pages><issn>0925-5710</issn><eissn>1865-3774</eissn><abstract>The optimal treatment for Philadelphia chromosome (Ph)-negative acute lymphoblastic leukemia (ALL) in first complete remission (CR1) has not been established in the high-intensity chemotherapy era. The outcomes of patients with Ph-negative ALL who underwent allogeneic hematopoietic stem cell transplantation (HSCT) from a human leukocyte antigen-matched related or unrelated donor in CR1 (HSCT-MRD group and HSCT-MUD group) were obtained from a Japanese registry database. Patients aged 16–24 years and 25–65 years were analyzed separately, and their outcomes were compared to those of patients who continued high-intensity chemotherapy in CR1 in studies (202U group and 202O group) by the Japan Adult Leukemia Study Group (JALSG). In the HSCT-MRD group, patients younger than 25 years had lower overall survival (OS) than the 202U group, presumably due to the higher non-relapse mortality (NRM) in the HSCT-MRD group. Patients 25 years and older had similar OS to the 202O group. The lower relapse rate was counterbalanced by higher NRM in the HSCT-MRD group. In the HSCT-MUD group, patients in both age groups had similar OS to their corresponding groups in the JALSG studies. In conclusion, high-intensity chemotherapy may change the role of HSCT for Ph-negative ALL.</abstract><cop>Singapore</cop><pub>Springer Singapore</pub><pmid>34328634</pmid><doi>10.1007/s12185-021-03198-4</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0002-2635-3395</orcidid></addata></record> |
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| ispartof | International journal of hematology, 2021-11, Vol.114 (5), p.608-619 |
| issn | 0925-5710 1865-3774 |
| language | eng |
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| subjects | Acute lymphoblastic leukemia Adult Aged Aged, 80 and over Antigens Antineoplastic Combined Chemotherapy Protocols - adverse effects Antineoplastic Combined Chemotherapy Protocols - therapeutic use Chemotherapy Clinical Decision-Making Combined Modality Therapy Disease Management Female Hematology Hematopoietic Stem Cell Transplantation Hematopoietic stem cells Histocompatibility antigen HLA Histocompatibility Testing Humans Leukemia Leukocytes Lymphatic leukemia Male Medicine Medicine & Public Health Middle Aged Mud Oncology Original Article Patients Philadelphia chromosome Precursor Cell Lymphoblastic Leukemia-Lymphoma - diagnosis Precursor Cell Lymphoblastic Leukemia-Lymphoma - drug therapy Precursor Cell Lymphoblastic Leukemia-Lymphoma - etiology Precursor Cell Lymphoblastic Leukemia-Lymphoma - mortality Prognosis Remission Remission (Medicine) Remission Induction Stem cell transplantation Stem cells Survival Analysis Transplantation Transplantation Conditioning Transplantation, Homologous Treatment Outcome |
| title | Optimal treatment for Philadelphia-negative acute lymphoblastic leukemia in first remission in the era of high-intensity chemotherapy |
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