Tehran University of Medical Sciences

Science Communicator Platform

Stay connected! Follow us on X network (Twitter):
Share this content! On (X network) By
Prognostic Factors Impacting Post-Transplant Outcomes in Adult T-Cell Acute Lymphoblastic Leukemia: A Registry-Based Study by the Ebmt Acute Leukemia Working Party Publisher Pubmed



El Cheikh J1 ; Ngoya M2 ; Galimard JE2 ; Remenyi P3 ; Kulagin A4 ; Aljurf M5 ; Mousavi A7 ; Wu D8 ; Ozcelik T9 ; Salmenniemi U10 ; Castillallorente C11 ; Socie G12 ; Helbig G13 ; Schroeder T14 Show All Authors
Authors
  1. El Cheikh J1
  2. Ngoya M2
  3. Galimard JE2
  4. Remenyi P3
  5. Kulagin A4
  6. Aljurf M5
  7. Mousavi A7
  8. Wu D8
  9. Ozcelik T9
  10. Salmenniemi U10
  11. Castillallorente C11
  12. Socie G12
  13. Helbig G13
  14. Schroeder T14
  15. Sakellari I15
  16. Rambaldi A16
  17. Burt R17
  18. Busca A18
  19. Balsat M19
  20. Stelljes M20
  21. Brissot E21
  22. Giebel S22
  23. Peric Z23
  24. Nagler A24
  25. Bazarbachi A1
  26. Ciceri F25
  27. Mohty M21
Show Affiliations
Authors Affiliations
  1. 1. Bone Marrow Transplantation Program, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
  2. 2. EBMT Statistical Unit, Saint Antoine Hospital, Sorbonne University, Paris, France
  3. 3. Del-pesti Centrumkorhaz –Orszagos Hematologiai es Infektologiai Intezet, Dept. Haematology and Stem Cell Transplant, Albert—Budapest, Budapest, Hungary
  4. 4. RM Gorbacheva Research Institute, Pavlov University, Saint Petersburg, Russian Federation
  5. 5. King Faisal Specialist Hospital & amp
  6. 6. Research Centre, Oncology (Section of Adult Haematolgy/BMT)—Riyadh, Riyadh, Saudi Arabia
  7. 7. Shariati Hospital, Hematology-Oncology and BMT Research—Teheran, Tehran, Iran
  8. 8. First Affiliated Hospital of Soochow University, Department of Hematology—Suzhou, Suzhou, China
  9. 9. Demiroglu Bilim University Istanbul Florence Nightingale Hospital, Hematopoietic SCT, Unit—Istanbul, Istanbul, Turkey
  10. 10. HUCH Comprehensive Cancer Center, Stem Cell Transplantation Unit—Helsinki, Helsinki, Finland
  11. 11. Gustave Roussy Cancer Campus, BMT Service, Department of Hematology—Villejuif, Villejuif, France
  12. 12. Hopital St. Louis, Dept. of Hematology—BMT—Paris, Paris, France
  13. 13. Silesian Medical Academy, University Department of Haematology and BMT—Katowice, Katowice, Poland
  14. 14. University Hospital, Department of Bone Marrow Transplantation—Essen, Essen, Germany
  15. 15. George Papanicolaou General Hospital, Haematology Department / BMT Unit—Thessaloniki, Thessaloniki, Greece
  16. 16. Department of Oncology and Hematology, University of Milan and Azienda Socio-Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy
  17. 17. University College London Hospital, Department of Haematology—London, London, United Kingdom
  18. 18. S.S.C.V.D Trapianto di Cellule Staminali, A.O.U Citta della Salute e della Scienza di Torino—Torino, Turin, Italy
  19. 19. Centre Hospitalier Lyon Sud, Service Hematologie—Lyon, Lyon, France
  20. 20. University of Muenster, Department of Hematol./Oncol.—Muenster, Munster, Germany
  21. 21. Sorbonne University, Clinical Hematology and Cellular Therapy Department, Saint Antoine, Hospital, INSERM UMRs 938, Paris, France
  22. 22. Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
  23. 23. School of Medicine, University Hospital Centre Zagreb, University of Zagreb, Zagreb, Croatia
  24. 24. Sheba Medical Center, Tel-Hashomer, Tel-Aviv University, Ramat-Gan, Israel
  25. 25. Ospedale San Raffaele s.r.l. Hematology and BMT, Milano, Italy

Source: Bone Marrow Transplantation Published:2024


Abstract

T-cell acute lymphoblastic leukemia (T-ALL) predominantly affects individuals in late childhood and young adulthood. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a curative modality particularly in the setting of poor risk genetics and/or persistent minimal residual disease. Limited studies have directly explored the impact of patient- and transplant-related factors on post-transplant outcomes in T-ALL. Using a large dataset from the European Society for Blood and Marrow Transplantation registry, we identified 1907 adult T-ALL patients (70% male) who underwent their first allo-HSCT in first complete remission (CR1) from matched sibling donors (MSD; 45%), unrelated donors (UD; 43%) or haploidentical donors (12%) between 2010 and 2021. The median age at transplant was 33.4 years (18.1–75). The median follow up was 2.9 years. Most patients underwent total body irradiation (TBI)-based myeloablative conditioning (69%). The 2-year overall survival (OS) was 69.4%, and leukemia -free survival (LFS) was 62.1%. In multivariate analysis, advanced age at transplant negatively affected LFS (for each 10-year increment, HR = 1.11, p = 0.004), GVHD-free, relapse-free survival (GRFS) (HR = 1.06, p = 0.04), OS (HR = 1.12, p = 0.002), and non-relapse mortality (NRM) (HR = 1.23, p < 0.001). More recent years of allo-HSCT were associated with improved GFRS (For each 3-year increment, HR = 0.89, p < 0.001), OS (HR = 0.9, p = 0.02), and decreased NRM (HR = 0.82, p = 0.008). TBI improved LFS. (HR = 0.79, p = 0.02), GRFS (HR = 0.83, p = 0.04), and relapse incidence (RI) (HR = 0.65, p < 0.001). Female-to-male transplant negatively affected GRFS (HR = 1.21, p = 0.02) and OS (HR = 1.23, p = 0.048). In vivo T-cell depletion significantly improved GFRS (HR = 0.74, p < 0.001). This large study identified prognostic factors, such as age at transplant conditioning regimen, in influencing post-transplant in adult T-ALL patients undergoing allo-HSCT. Importantly, a significant improvement over time was noted. These findings hold great promise for new adapted treatment strategies and can serve as a benchmark for future studies in that setting. © The Author(s), under exclusive licence to Springer Nature Limited 2024.
Related Docs
1. Impact of Anti-Thymocyte Globulin on Results of Allogeneic Peripheral Blood Stem Cell Transplantation for Patients With Philadelphia-Positive Acute Lymphoblastic Leukaemia: An Analysis by the Acute Leukemia Working Party of the Ebmt, European Journal of Cancer (2019)
2. Outcome of Haploidentical Versus Matched Sibling Donors in Hematopoietic Stem Cell Transplantation for Adult Patients With Acute Lymphoblastic Leukemia: A Study From the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation, Journal of Hematology and Oncology (2021)