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Annals of Hematology
Published in: Annals of Hematology 1/2021

01-01-2021 | Acute Lymphoblastic Leukemia | Original Article

Outcome predictors after retransplantation in relapsed acute lymphoblastic leukemia: a multicenter, retrospective study

Authors: Yasuo Mori, Kensuke Sasaki, Yoshikiyo Ito, Takuro Kuriyama, Toshiyuki Ueno, Masanori Kadowaki, Takatoshi Aoki, Takeshi Sugio, Goichi Yoshimoto, Koji Kato, Takahiro Maeda, Koji Nagafuji, Koichi Akashi, Toshihiro Miyamoto, Fukuoka Blood and Marrow Transplantation Group

Published in: Annals of Hematology | Issue 1/2021

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Abstract

Retransplantation is the only curative treatment option for patients with acute lymphoblastic leukemia (ALL) that has relapsed after allogeneic hematopoietic cell transplantation (allo-HCT); however, data in this setting remain scant. Hence, this multicenter, retrospective study aims to determine outcome predictors after retransplantation in relapsed ALL. We examined 55 recipients who underwent multiple allo-HCTs during 2006–2018. The 2-year overall survival (OS), progression-free survival (PFS), and non-relapse mortality rates were 35.9%, 29.1%, and 23.6%, respectively. We observed a trend of better outcome in Ph + ALL (n = 22) patients compared with non-Ph ALL (n = 33) patients; the 2-year PFS was 40.9% versus 21.2%, indicating a beneficial effect of more potent second- or third-generation tyrosine kinase inhibitors. Univariate analysis revealed that late relapse after the previous transplant was the only significant predictor of better transplant outcome among Ph + ALL patients, whereas factors related to prolonged OS/PFS in non-Ph ALL patients were late relapse after the previous transplant, longer duration from disease relapse/progression to second or more allo-HCT, disease status at the transplantation, and good performance status. Nevertheless, further investigations are warranted to determine whether novel molecular-targeted agents with higher efficacy and fewer toxicities could exceed conventional chemotherapies as a bridging strategy to next allo-HCT and improve the outcomes of non-Ph ALL patients.
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Metadata
Title
Outcome predictors after retransplantation in relapsed acute lymphoblastic leukemia: a multicenter, retrospective study
Authors
Yasuo Mori
Kensuke Sasaki
Yoshikiyo Ito
Takuro Kuriyama
Toshiyuki Ueno
Masanori Kadowaki
Takatoshi Aoki
Takeshi Sugio
Goichi Yoshimoto
Koji Kato
Takahiro Maeda
Koji Nagafuji
Koichi Akashi
Toshihiro Miyamoto
Fukuoka Blood and Marrow Transplantation Group
Publication date
01-01-2021
Publisher
Springer Berlin Heidelberg
Published in
Annals of Hematology / Issue 1/2021
Print ISSN: 0939-5555
Electronic ISSN: 1432-0584
DOI
https://doi.org/10.1007/s00277-020-04310-0

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