Contributions
Abstract: PB1635
Type: Publication Only
Background
Refractory or relapse remains a major obstacle in improving outcomes of patients with acute lymphoblastic leukemia (ALL). And allogeneic hematopoietic stem cell transplant (allo-HSCT) was the only curative treatment option for these patients. However, whether an allo-HSCT was performed in status of advanced stage or in setting of remission after salvage chemotherapy, there is no standard of care.
Aims
To evaluate the impact of disease status on the outcomes of allo-HSCT in the treatment of patients with refractory and relapsed ALL.
Methods
52 patients with refractory and relapsed ALL, including 19 cases in advanced stage (nonremission, NR) and 33 cases in more than or equal to second complete remission(≥CR2), received allo-HSCT after myeloablative conditioning regimen in our department.
Results
51 patients engrafted successfully. The transplantation-related mortality (TRM) rate of NR and ≥CR2 was 10.5% vs 12.1% (P=0.815). The incidence of aGVHD was 52.6% vs 57.6% (P=0.730), including 42.1% vs 33.3% (P=0.527) with mild (grade I-II) and 10.5% vs 24.3% (P=0.399) with severe (grade III-IV) aGVHD. The incidence of cGVHD was similar also(41.6% vs 57.9%, P=0.660). With a median follow-up of 12(1.8-44.5) months, the cumulative relapse rate of NR and ≥CR2 was 47% vs 34.3%（P=0.425) respectively. The estimated 2 year overall survival (OS) and 2 year leukemia-free survival (LFS) rate were 42.6% vs 45.7% (P=0.487) and 46.3% vs 46.2% (P=0.571) respectively. Multivariate Analysis results showed that cGVHD was independent favorable risk factor for OS and LFS of R/R ALL．For relapsed patients, OS was significantly better with first CR duration>6 month and time to transplant≤2 months.
Conclusion
AlIo-HSCT is an effective salvage treatment option for patients with refractory and relapsed ALL. Our retrospective analysis showed that R/R ALL with different status prior transplant had similar outcome post transplantation.
Session topic: 2. Acute lymphoblastic leukemia - Clinical
Keyword(s): Acute lymphoblastic leukemia, Relapse, Refractory, Allogeneic hematopoietic stem cell transplant
Abstract: PB1635
Type: Publication Only
Background
Refractory or relapse remains a major obstacle in improving outcomes of patients with acute lymphoblastic leukemia (ALL). And allogeneic hematopoietic stem cell transplant (allo-HSCT) was the only curative treatment option for these patients. However, whether an allo-HSCT was performed in status of advanced stage or in setting of remission after salvage chemotherapy, there is no standard of care.
Aims
To evaluate the impact of disease status on the outcomes of allo-HSCT in the treatment of patients with refractory and relapsed ALL.
Methods
52 patients with refractory and relapsed ALL, including 19 cases in advanced stage (nonremission, NR) and 33 cases in more than or equal to second complete remission(≥CR2), received allo-HSCT after myeloablative conditioning regimen in our department.
Results
51 patients engrafted successfully. The transplantation-related mortality (TRM) rate of NR and ≥CR2 was 10.5% vs 12.1% (P=0.815). The incidence of aGVHD was 52.6% vs 57.6% (P=0.730), including 42.1% vs 33.3% (P=0.527) with mild (grade I-II) and 10.5% vs 24.3% (P=0.399) with severe (grade III-IV) aGVHD. The incidence of cGVHD was similar also(41.6% vs 57.9%, P=0.660). With a median follow-up of 12(1.8-44.5) months, the cumulative relapse rate of NR and ≥CR2 was 47% vs 34.3%（P=0.425) respectively. The estimated 2 year overall survival (OS) and 2 year leukemia-free survival (LFS) rate were 42.6% vs 45.7% (P=0.487) and 46.3% vs 46.2% (P=0.571) respectively. Multivariate Analysis results showed that cGVHD was independent favorable risk factor for OS and LFS of R/R ALL．For relapsed patients, OS was significantly better with first CR duration>6 month and time to transplant≤2 months.
Conclusion
AlIo-HSCT is an effective salvage treatment option for patients with refractory and relapsed ALL. Our retrospective analysis showed that R/R ALL with different status prior transplant had similar outcome post transplantation.
Session topic: 2. Acute lymphoblastic leukemia - Clinical
Keyword(s): Acute lymphoblastic leukemia, Relapse, Refractory, Allogeneic hematopoietic stem cell transplant