Open AccessPB2346 RISK FACTORS ANALYSIS FOR DISEASE RECURRENCE AFTER ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION IN PATIENTS WITH HIGH‐RISK ACUTE LEUKEMIA
Author(s) -
Zhang R.,
Wu Q.,
Jiang Z.,
Wan D.,
Li L.,
Xia L.
Publication year - 2019
Publication title -
hemasphere
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.677
H-Index - 11
ISSN - 2572-9241
DOI - 10.1097/01.hs9.0000567848.05953.f0
Subject(s) - medicine , cumulative incidence , transplantation , hematopoietic stem cell transplantation , acute leukemia , multivariate analysis , leukemia , disease , incidence (geometry) , oncology , surgery , physics , optics
Background: Relapse is a major cause of treatment failure for high‐risk acute leukemia after allogeneic hematopoietic stem cell transplantation (allo‐HSCT). Prognosis is considered dismal but data about risk factors associated with disease recurrence have not been elucidated. Aims: We aim to explore the pre‐ and post‐transplantation risk factors on relapse and survival in order to formulate individualized prophylaxis and treatment protocol for primary reoccurrence in high‐risk patients before and after transplantation. Methods: We retrospectively analyzed the outcomes of 321 high‐risk acute leukemia patients who underwent allogeneic hematopoietic stem cell transplantation (allo‐HSCT) who were diagnosed and treated at Union Hospital, and further evaluated the impact of pre‐ and post‐transplantation risk factors on relapse and survival by multivariate analysis. Results: Overall, 104 patients relapsed after allo‐HSCT with relapse cumulative incidence of 31 ± 2%. The median time of relapse was 4 (1.5‐26) months. With a median follow‐up of 50 months, the 3‐year overall survival (OS) and disease‐free survival (DFS) were 70%, 60%, respectively. Multivariate analysis showed that conditioning regimen (HR, 0.309; 95% CI, 0.119‐0.806, p = 0.016), type of disease (HR, 0.335; 95% CI, 0.125‐0.896, p = 0.029), and disease status at transplantation (HR, 1.964; 95% CI, 1.156‐3.338, p = 0.013) were independent factors influencing relapse for high‐risk acute leukemia patients following allo‐HSCT. Summary/Conclusion: Since the prognosis of patients with acute leukemia who experienced relapse after allo‐HSCT was poor, we emphasize the urgent need for formulating individualized prophylaxis and treatment protocol for primary reoccurrence in high‐risk patients before and after transplantation.