Prognosis of patients with acute lymphoblastic leukaemia relapsing after allogeneic stem cell transplantation. (18th March 2023)

• Record Type: Journal Article
• Authors: Ferra Coll, Christelle; Morgades de la Fe, Mireia; Prieto García, Laura; Vaz, Carlos Pinho; Heras Fernando, María Inmaculada; Bailen Almorox, Rebeca; Garcia‐Cadenas, Irene; Calabuig Muñoz, Marisa; Ripa, Teresa Zudaire; Zanabili Al‐Sibai, Joud; Novoa, Sandra; Aguado, Beatriz; Torrent Catarineu, Anna; López‐Godino, Oriana; Martino Bofarull, Rodrigo; Kwon, Mi; Campos Júnior, Antonio; Caballero Barrigón, Dolores; Ribera Santasusana, Josep‐Maria
• Is Part Of: European journal of haematology. Volume 110:Number 6(2023)
• Page Start: 659
• Page End: 668
• Publication Date: 2023-03-18
• Subjects: acute lymphoblastic leukaemia -- allogeneic haematopoietic stem cell transplant -- relapse; Hematology -- Periodicals; Blood -- Diseases -- Periodicals; Blood -- Periodicals; 616.15005
• DOI: 10.1111/ejh.13947
• Languages: English
• ISSNs: 0902-4441

Abstract

Abstract: The outcomes of patients with acute lymphoblastic leukaemia (ALL) presenting relapse after allogeneic stem cell transplant (allo‐SCT) are poor, with few data available in this setting. Objective and Methods: To evaluate the outcomes of patients with ALL presenting relapsed after allo‐SCT, we performed a retrospective study including 132 from 11 centres in Spain. Results: Therapeutic strategies consisted of palliative treatment ( n = 22), chemotherapy ( n = 82), tyrosine kinase inhibitors ( n = 26), immunotherapy with inotuzumab and/or blinatumumab ( n = 19), donor lymphocyte infusions ( n = 29 pts), second allo‐SCT ( n = 37) and CAR T therapy ( n = 14). The probability of overall survival (OS) at 1 and 5 years after relapse was 44% (95% confidence interval [CI]: 36%; 52%) and 19% (95% CI: 11%; 27%). In the 37 patients undergoing a second allo‐SCT, the 5‐year estimated OS probability was 40% [22%; 58%]. Younger age, recent allo‐SCT, late relapse, 1st complete remission at 1st allo‐SCT and chronic graft‐versus‐host disease confirmed their positive impact on survival in the multivariable analysis. Conclusion: Despite the poor prognosis of patients with ALL presenting relapse after a first allo‐SCT, some can be satisfactorily rescued and a second allo‐SCT still remains a valid option for selected patients. Moreover, emerging therapies really might improve ALL patients outcome when relapsing after an allo‐SCT.