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Outcomes of therapy‐related acute lymphoblastic leukemia in adults after allogeneic stem cell transplantation
Author(s) -
Vasudevan Nampoothiri Ram,
Law Arjun Datt,
Lam Wilson,
Chen Carol,
AlShaibani Zeyad,
Loach David,
Michelis Fotios V.,
Kim Dennis Dong Hwan,
Mattsson Jonas,
Kumar Rajat,
Lipton Jeffrey Howard,
Viswabandya Auro
Publication year - 2020
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.13403
Subject(s) - medicine , hematopoietic stem cell transplantation , transplantation , malignancy , lymphoblastic leukemia , multivariate analysis , oncology , leukemia , acute leukemia , stem cell , biology , genetics
Therapy‐related acute lymphoblastic leukemia (t‐ALL) is an increasingly recognized subset of therapy‐related acute leukemia. There are limited data on the role of allogeneic hematopoietic stem cell transplantation (HSCT) in t‐ALL. Recent reports suggest comparable outcomes of t‐ALL with de novo ALL after HSCT. Patients and Methods We retrospectively reviewed all patients of t‐ALL who underwent HSCT at our center. Patients were analyzed for prior malignancy, therapy, time to diagnosis of t‐ALL, clinical, laboratory characteristics, transplant details, relapse‐free survival (RFS), and overall survival (OS). Results Eighteen patients (M:F ratio 1:1; Median age 44 years) underwent HSCT for t‐ALL. Median latent period from primary malignancy to t‐ALL was 44.8 months. 11q23 rearrangement and t(9;22) were present in 33.3% and 22.2% patients, respectively. Stem cell donors were matched related, matched unrelated, and haploidentical in 27.8% (n = 5), 55.6% (n = 10), and 16.7% (n = 3) patients, respectively. Five patients died before D+ 100 (27.8%). Estimated 2‐year RFS and OS were 47.1% and 51.8%, respectively. We did not find any pretransplant and post‐transplant risk factors that were predictive of improved OS or RFS after multivariate analysis. Conclusions Allogeneic HSCT outcomes in t‐ALL were comparable to HSCT outcomes in de novo ALL. Multicenter studies with more patients and longer follow‐up may provide factors affecting outcome and survival.