Improved post‐transplant outcomes since 2000 for Ph‐positive acute lymphoblastic leukemia in first remission: A study from the EBMT Acute Leukemia Working Party
Year: 2025
Type: article
Study design: Observational Study
Abstract: Allogeneic hematopoietic cell transplantation (allo‐HCT) remains a curative treatment for patients with Philadelphia chromosome‐positive acute lymphoblastic leukemia (Ph+ ALL) in their first complete remission (CR1). Recent results using the combination of blinatumomab and second‐ or third‐generation tyrosine kinase inhibitors have challenged the necessity of allo‐HCT in CR1. Here we assessed real‐world changes over time in transplant characteristics and outcomes in adult patients with Ph+ ALL in CR1, using a large dataset from the European Society for Blood and Marrow Transplantation registry. A total of 3292 patients (45% female; median age 45 years) who underwent allo‐HCT from 2001 to 2020 were included. Over four periods (2001–2005, 2006–2010, 2011–2015, and 2016–2020), the 3‐year cumulative incidence of relapse decreased from 41% to 19%, and non‐relapse mortality decreased from 25% to 17% (p < 0.001 for both). Correspondingly, 3‐year leukemia‐free survival (LFS) improved from 34% to 64%, and overall survival (OS) from 47% to 75% (p < 0.001 for both). Graft versus host disease‐free and relapse‐free survival also improved from 26% to 49% (p < 0.001). Factors negatively affecting LFS included older age, male gender, male donor and measurable residual disease (MRD) positivity pre‐transplant, while total body conditioning (TBI) positively affected LFS. OS was positively influenced by younger age, female gender, matched sibling donor, TBI, and T cell depletion. Importantly, improvement in post‐transplant outcomes over time was observed regardless of pre‐transplant MRD status. In conclusion, we observed an impressive improvement over time in post‐transplant outcomes of Ph+ ALL. These large‐scale data can serve as a benchmark for future studies.
Source: HemaSphere
DOI: 10.1002/hem3.70117
Authors: Ali Bazarbachi, Myriam Labopin, Iman Abou Dalle, Ibrahim Yakoub‐Agha, Gérard Socié, Thomas Schroeder, Didier Blaise, Xavier Poiré, Marie Balsat, Urpu Salmenniemi, Nicolaus Kröger, Alexander Kulagin, Eva Maria Wagner‐Drouet, Depei Wu, Eolia Brissot, Arnon Nagler, Sebastian Giebel, Fabio Ciceri, Mohamad Mohty
Institutions: American University of Beirut Medical Center, Inserm, Sorbonne Université, Hôpital Saint-Antoine, Centre de Recherche Saint-Antoine, Centre Hospitalier Universitaire de Lille, Hôpital Saint-Louis, Essen University Hospital, Cliniques Universitaires Saint-Luc, Hôpital Lyon Sud, Helsinki University Hospital, Universität Hamburg, University Medical Center Hamburg-Eppendorf, First Pavlov State Medical University of St. Petersburg, University Medical Center of the Johannes Gutenberg University Mainz, First Affiliated Hospital of Soochow University, Sheba Medical Center, The Maria Sklodowska-Curie National Research Institute of Oncology, Vita-Salute San Raffaele University, IRCCS Ospedale San Raffaele
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,480
OpenAlex ID: W4409395995