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

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 performe...

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Published in:European journal of haematology 2023-06, Vol.110 (6), p.659-668
Main 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
Format: Article
Language:English
Subjects:
Acute Disease
acute lymphoblastic leukaemia
Acute lymphoblastic leukemia
allogeneic haematopoietic stem cell transplant
Allografts
Chemotherapy
Hematopoietic Stem Cell Transplantation - adverse effects
Humans
Immunotherapy
Leukemia
Lymphocytes
Medical prognosis
Neoplasm Recurrence, Local
Precursor Cell Lymphoblastic Leukemia-Lymphoma - diagnosis
Precursor Cell Lymphoblastic Leukemia-Lymphoma - etiology
Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy
Prognosis
Protein-tyrosine kinase
Recurrence
relapse
Remission
Retrospective Studies
Stem Cell Transplantation
Stem cells
Transplantation, Homologous
Transplants & implants
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Summary: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.
ISSN:0902-4441
1600-0609
DOI:10.1111/ejh.13947