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. 2023 Jun;110(6):659-668.
doi: 10.1111/ejh.13947. Epub 2023 Mar 18.

Prognosis of patients with acute lymphoblastic leukaemia relapsing after allogeneic stem cell transplantation

Christelle Ferra Coll  1   2 , Mireia Morgades de la Fe  1 , Laura Prieto García  3 , Carlos Pinho Vaz  4 , María Inmaculada Heras Fernando  5 , Rebeca Bailen Almorox  6 , Irene Garcia-Cadenas  7 , Marisa Calabuig Muñoz  8 , Teresa Zudaire Ripa  9 , Joud Zanabili Al-Sibai  10 , Sandra Novoa  11 , Beatriz Aguado  12 , Anna Torrent Catarineu  1 , Oriana López-Godino  5 , Rodrigo Martino Bofarull  7 , Mi Kwon  6 , Antonio Campos Júnior  4 , Dolores Caballero Barrigón  3 , Josep-Maria Ribera Santasusana  1
Affiliations

Prognosis of patients with acute lymphoblastic leukaemia relapsing after allogeneic stem cell transplantation

Christelle Ferra Coll et al. Eur J Haematol. 2023 Jun.

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.

Keywords: acute lymphoblastic leukaemia; allogeneic haematopoietic stem cell transplant; relapse.

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References

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