Contributions
Abstract: PB1630
Type: Publication Only
Background
The majority of children with acute lymphoblastic leukemia (ALL) can be definitively cured through the use of risk-oriented chemotherapy protocols. However, there are still subsets of children with ALL in whom the probability of survival with chemotherapy alone remains unsatisfactory, because of the high chance of disease recurrence. In this study, we analyzed the feasibility and results of allogenic stem cell transplantation for high-risk ALL of children and young adults.
Aims
In this study, we analyzed the feasibility and results of allogenic stem cell transplantation for high-risk ALL of children and young adults.
Methods
Between January 2000 and December 2015, 72 patients (27%) aged less than 30 years, with high-risk ALL in first complete remission treated with a frontline EORTC 58951 pediatric protocol, underwent allogeneic stem cell transplantation (HSCT). For these patients, we studied the indication of the allograft, the search of HLA intra-familial sibling donor, the feasibility and the results of the allograft performed at the National Center for bone marrow transplantation in Tunis.
Results
Seventy patients with high risk ALL were eligible for allogenic SCT. Among them 57 patients (81%) who realized the HLA study and 34 (60%) had at least one HLA-identical siblings donor. The allograft has been performed for only 18 patients (32%): 2 patients had relapsed before allograft, five patients had a severe infection with impaired general condition and the others patients had refused allograft SCT. With a median follow-up of 6 years, 11 allografted patients (61%) are still alive in complete remission (RC), 4 patients have relapsed (at 7, 9, 10 and 12 months). The transplant-related mortality was 17%. Among the 45 patients who were not allografts, 18 were living in CR (40%), 8 had died in post induction chemotherapy, and 17 had relapsed (38%).
Conclusion
In our study, despite the presence of HLA-identical siblings donor in 50% of cases, bone marrow allograft was proposed for only 28% of patients less than to Western series 60% of cases (HLA-identical sibling, a matched unrelated donor or cord blood). Allogenic stem cell transplantation in high risk acute lymphoblastic leukemia of child give interesting responses with 2/3 of patients are alive without relapse in our study, comparable to the literature (60 to 70% at 5 years). To further improve the results, it is necessary to expand donor sources such as matched unrelated donor and cord blood transplantation.
Session topic: 2. Acute lymphoblastic leukemia - Clinical
Keyword(s): Acute lymphoblastic leukemia, Allogeneic bone marrow transplant, High risk
Abstract: PB1630
Type: Publication Only
Background
The majority of children with acute lymphoblastic leukemia (ALL) can be definitively cured through the use of risk-oriented chemotherapy protocols. However, there are still subsets of children with ALL in whom the probability of survival with chemotherapy alone remains unsatisfactory, because of the high chance of disease recurrence. In this study, we analyzed the feasibility and results of allogenic stem cell transplantation for high-risk ALL of children and young adults.
Aims
In this study, we analyzed the feasibility and results of allogenic stem cell transplantation for high-risk ALL of children and young adults.
Methods
Between January 2000 and December 2015, 72 patients (27%) aged less than 30 years, with high-risk ALL in first complete remission treated with a frontline EORTC 58951 pediatric protocol, underwent allogeneic stem cell transplantation (HSCT). For these patients, we studied the indication of the allograft, the search of HLA intra-familial sibling donor, the feasibility and the results of the allograft performed at the National Center for bone marrow transplantation in Tunis.
Results
Seventy patients with high risk ALL were eligible for allogenic SCT. Among them 57 patients (81%) who realized the HLA study and 34 (60%) had at least one HLA-identical siblings donor. The allograft has been performed for only 18 patients (32%): 2 patients had relapsed before allograft, five patients had a severe infection with impaired general condition and the others patients had refused allograft SCT. With a median follow-up of 6 years, 11 allografted patients (61%) are still alive in complete remission (RC), 4 patients have relapsed (at 7, 9, 10 and 12 months). The transplant-related mortality was 17%. Among the 45 patients who were not allografts, 18 were living in CR (40%), 8 had died in post induction chemotherapy, and 17 had relapsed (38%).
Conclusion
In our study, despite the presence of HLA-identical siblings donor in 50% of cases, bone marrow allograft was proposed for only 28% of patients less than to Western series 60% of cases (HLA-identical sibling, a matched unrelated donor or cord blood). Allogenic stem cell transplantation in high risk acute lymphoblastic leukemia of child give interesting responses with 2/3 of patients are alive without relapse in our study, comparable to the literature (60 to 70% at 5 years). To further improve the results, it is necessary to expand donor sources such as matched unrelated donor and cord blood transplantation.
Session topic: 2. Acute lymphoblastic leukemia - Clinical
Keyword(s): Acute lymphoblastic leukemia, Allogeneic bone marrow transplant, High risk