Oncology Frontier: Allotransplant for older patients with acute lymphoblastic leukemia: does it work?

　　《肿瘤瞭望》：异基因干细胞移植对老年ALL患者是否有效？

　　Dr Marks: Within our new UKALL XIV study (which is our major study from the age of 25 to 65)， reduced intensity allografting has a big role. Because of the very poor outcomes in older patients in our previous study， UKALL XII/ECOG E2993， where there was only 15% long-term survival， we are prospectively studying reduced intensity allografting. To be eligible for this， they have to be over the age of 40 and they have to have a sibling donor or a well-matched unrelated donor. We have some preliminary data in about 80 patients and it is looking very promising. We need much longer follow-ups to determine relapse rates， but so far， I can say that the transplant-related mortality in this group is about 15%， which is reasonable， and early survival looks promising. In this setting we are using fludarabine， melphalan and alemtuzumab (an in-vivo T-cell depleted strategy)， we may see an excess of relapse. We are starting to see some relapses and we need much longer follow-ups to know if it will be successful.

　　Marks教授：我们正在进行一项新的研究（主要目标人群年龄25~65岁），在这项研究中减低强度的异基因移植效果非常好。根据我们既往的研究结果显示，老年患者的治疗结果非常差，仅有15%长期生存，因此我们正在尝试减低强度异基因移植，并观察其作用。研究纳入年龄大于40岁的患者，需有同胞供者或匹配良好的无关供者。目前已获得近80例患者的初步数据，初步看来具有一定的治疗前景，但仍需要更长的随访以明确复发。