Details

Autor(en) / Beteiligte

• Mori, Yasuo
• Sasaki, Kensuke
• Ito, Yoshikiyo
• Kuriyama, Takuro
• Ueno, Toshiyuki
• Kadowaki, Masanori
• Aoki, Takatoshi
• Sugio, Takeshi
• Yoshimoto, Goichi
• Kato, Koji
• Maeda, Takahiro
• Nagafuji, Koji
• Akashi, Koichi
• Miyamoto, Toshihiro

Titel

Outcome predictors after retransplantation in relapsed acute lymphoblastic leukemia: a multicenter, retrospective study

Ist Teil von

• Annals of hematology, 2021-01, Vol.100 (1), p.197-208

Ort / Verlag

Berlin/Heidelberg: Springer Berlin Heidelberg

Erscheinungsjahr

2021

Quelle

MEDLINE

Beschreibungen/Notizen

• Retransplantation is the only curative treatment option for patients with acute lymphoblastic leukemia (ALL) that has relapsed after allogeneic hematopoietic cell transplantation (allo-HCT); however, data in this setting remain scant. Hence, this multicenter, retrospective study aims to determine outcome predictors after retransplantation in relapsed ALL. We examined 55 recipients who underwent multiple allo-HCTs during 2006–2018. The 2-year overall survival (OS), progression-free survival (PFS), and non-relapse mortality rates were 35.9%, 29.1%, and 23.6%, respectively. We observed a trend of better outcome in Ph + ALL ( n  = 22) patients compared with non-Ph ALL ( n  = 33) patients; the 2-year PFS was 40.9% versus 21.2%, indicating a beneficial effect of more potent second- or third-generation tyrosine kinase inhibitors. Univariate analysis revealed that late relapse after the previous transplant was the only significant predictor of better transplant outcome among Ph + ALL patients, whereas factors related to prolonged OS/PFS in non-Ph ALL patients were late relapse after the previous transplant, longer duration from disease relapse/progression to second or more allo-HCT, disease status at the transplantation, and good performance status. Nevertheless, further investigations are warranted to determine whether novel molecular-targeted agents with higher efficacy and fewer toxicities could exceed conventional chemotherapies as a bridging strategy to next allo-HCT and improve the outcomes of non-Ph ALL patients.