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Outcomes and prognostic factors of adults with acute lymphoblastic leukemia who relapse after allogeneic hematopoietic cell transplantation. An analysis on behalf of the Acute Leukemia Working Party of EBMT

Spyridonidis, A.; Labopin, M.; Schmid, C.; Volin, L.; Yakoub-Agha, I.; Stadler, M.; Milpied, N.; Socie, G.; Browne, P. and Lenhoff, Stig LU , et al. (2012) In Leukemia 26(6). p.1211-1217
Abstract
To describe outcomes, treatment and prognostic factors that influence survival of adult patients with acute lymphoblastic leukemia (ALL), who relapsed after allogeneic hematopoietic cell transplantation (HCT), we retrospectively analyzed 465 ALL adult patients from European Group for Blood and Marrow Transplantation (EBMT) centers who relapsed after a first HCT performed in complete remission (CR1 65%, CR2/3 35%). Salvage treatments were: supportive care (13%), cytoreductive therapy (43%), donor lymphocyte infusion without or with prior chemotherapy (23%) and second HCT (20%). Median time from HCT to relapse was 6.9 months, median follow-up was 46 months and median survival after relapse was 5.5 months. Estimated 1-, 2- and 5-year... (More)
To describe outcomes, treatment and prognostic factors that influence survival of adult patients with acute lymphoblastic leukemia (ALL), who relapsed after allogeneic hematopoietic cell transplantation (HCT), we retrospectively analyzed 465 ALL adult patients from European Group for Blood and Marrow Transplantation (EBMT) centers who relapsed after a first HCT performed in complete remission (CR1 65%, CR2/3 35%). Salvage treatments were: supportive care (13%), cytoreductive therapy (43%), donor lymphocyte infusion without or with prior chemotherapy (23%) and second HCT (20%). Median time from HCT to relapse was 6.9 months, median follow-up was 46 months and median survival after relapse was 5.5 months. Estimated 1-, 2- and 5-year post-relapse survival was 30 +/- 2%, 16 +/- 2% and 8 +/- 1%, respectively. In a multivariate analysis, adverse factors for survival were: late CR (CR2/3) at transplant (P<0.012), early relapse after transplant (<6.9 months, P <0.0001) and peripheral blast percent at relapse (P <0.0001). On the basis of multivariate model for survival, three groups of patients were identified with estimated 2 year survival of 6 +/- 2, 17 +/- 3 and 30 +/- 7%. Outcome of ALL patients relapsing after HCT is dismal and there is a need for new therapies. Our study provides the standard expectations in ALL relapse and may help in the decision of post-relapse therapy. (Less)
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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
ALL, relapse, hematopoietic cell transplantation
in
Leukemia
volume
26
issue
6
pages
1211 - 1217
publisher
Nature Publishing Group
external identifiers
  • wos:000305081000008
  • scopus:84862000695
ISSN
1476-5551
DOI
10.1038/leu.2011.351
language
English
LU publication?
yes
id
9ebad4c9-3890-4d1c-91d0-d6d5a2b59ca2 (old id 2892335)
date added to LUP
2012-08-01 08:53:27
date last changed
2017-11-05 04:11:56
@article{9ebad4c9-3890-4d1c-91d0-d6d5a2b59ca2,
  abstract     = {To describe outcomes, treatment and prognostic factors that influence survival of adult patients with acute lymphoblastic leukemia (ALL), who relapsed after allogeneic hematopoietic cell transplantation (HCT), we retrospectively analyzed 465 ALL adult patients from European Group for Blood and Marrow Transplantation (EBMT) centers who relapsed after a first HCT performed in complete remission (CR1 65%, CR2/3 35%). Salvage treatments were: supportive care (13%), cytoreductive therapy (43%), donor lymphocyte infusion without or with prior chemotherapy (23%) and second HCT (20%). Median time from HCT to relapse was 6.9 months, median follow-up was 46 months and median survival after relapse was 5.5 months. Estimated 1-, 2- and 5-year post-relapse survival was 30 +/- 2%, 16 +/- 2% and 8 +/- 1%, respectively. In a multivariate analysis, adverse factors for survival were: late CR (CR2/3) at transplant (P&lt;0.012), early relapse after transplant (&lt;6.9 months, P &lt;0.0001) and peripheral blast percent at relapse (P &lt;0.0001). On the basis of multivariate model for survival, three groups of patients were identified with estimated 2 year survival of 6 +/- 2, 17 +/- 3 and 30 +/- 7%. Outcome of ALL patients relapsing after HCT is dismal and there is a need for new therapies. Our study provides the standard expectations in ALL relapse and may help in the decision of post-relapse therapy.},
  author       = {Spyridonidis, A. and Labopin, M. and Schmid, C. and Volin, L. and Yakoub-Agha, I. and Stadler, M. and Milpied, N. and Socie, G. and Browne, P. and Lenhoff, Stig and Sanz, M. A. and Aljurf, M. and Mohty, M. and Rocha, V.},
  issn         = {1476-5551},
  keyword      = {ALL,relapse,hematopoietic cell transplantation},
  language     = {eng},
  number       = {6},
  pages        = {1211--1217},
  publisher    = {Nature Publishing Group},
  series       = {Leukemia},
  title        = {Outcomes and prognostic factors of adults with acute lymphoblastic leukemia who relapse after allogeneic hematopoietic cell transplantation. An analysis on behalf of the Acute Leukemia Working Party of EBMT},
  url          = {http://dx.doi.org/10.1038/leu.2011.351},
  volume       = {26},
  year         = {2012},
}