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01-07-2020 | Acute Lymphoblastic Leukemia | Original Article

Comparison of central nervous system relapse outcomes following haploidentical vs identical-sibling transplant for acute lymphoblastic leukemia

Authors: Qi Chen, Xin Zhao, Hai-xia Fu, Yu-hong Chen, Yuan-yuan Zhang, Jing-zhi Wang, Yu Wang, Chen-hua Yan, Feng-rong Wang, Xiao-dong Mo, Wei Han, Huan Chen, Ying-jun Chang, Lan-ping Xu, Kai-yan Liu, Xiao-jun Huang, Xiao-hui Zhang

Published in: Annals of Hematology | Issue 7/2020

Abstract

To explore the incidence, risk factors, and outcomes of central nervous system (CNS) relapse after allogeneic hematopoietic stem cell transplantation (allo-HSCT) for acute lymphoblastic leukemia (ALL) and to compare the differences in CNS relapse between haploidentical donor HSCT (HID-HSCT) and HLA-identical sibling donor HSCT (ISD-HSCT). We performed a retrospective nested case-control study on patients with CNS relapse after allo-HSCT. The cumulative incidence of CNS relapse was 4.06% after allo-HSCT in ALL, with a significantly poor prognosis. The incidence was 3.91% and 5.36% in HID-HSCT and ISD-HSCT, respectively (p = .227). Among the patients with CNS relapse, the overall survival (OS) at 3 years was 56.2 ± 6.8% in the HID-HSCT subgroup and 76.9 ± 10.2% in the ISD-HSCT subgroup (p = .176). The 3-year cumulative incidence of systemic relapse was also comparable between the two subgroups (HID-HSCT, 40.6 ± 7.4%; ISD-HSCT, 13.3 ± 8.7%, respectively, p = .085). Younger age (p = .045), T-ALL (p = .035), hyperleukocytosis at diagnosis (p < .001), advanced disease stage at transplant (p < .001), pre-HSCT CNS involvement (p < .001), and absence of chronic graft vs host disease (cGVHD) (p < .001) were independent risk factors for CNS relapse after allo-HSCT. In conclusion, CNS relapse was a significant complication after allo-HSCT in ALL and was associated with poor prognosis. The incidences and outcomes were comparable between HID-HSCT and ISD-HSCT.

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Title: Comparison of central nervous system relapse outcomes following haploidentical vs identical-sibling transplant for acute lymphoblastic leukemia
Authors: Qi Chen
Xin Zhao
Hai-xia Fu
Yu-hong Chen
Yuan-yuan Zhang
Jing-zhi Wang
Yu Wang
Chen-hua Yan
Feng-rong Wang
Xiao-dong Mo
Wei Han
Huan Chen
Ying-jun Chang
Lan-ping Xu
Kai-yan Liu
Xiao-jun Huang
Xiao-hui Zhang
Publication date: 01-07-2020
Publisher: Springer Berlin Heidelberg
Keywords: Acute Lymphoblastic Leukemia
Stem Cell Transplantation
Stem Cell Transplantion
Stem Cell Transplantation
Published in: Annals of Hematology / Issue 7/2020
Print ISSN: 0939-5555
Electronic ISSN: 1432-0584
DOI: https://doi.org/10.1007/s00277-020-04080-9

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