Published online Nov 30, 2018. doi: 10.5500/wjt.v8.i7.252
Peer-review started: May 25, 2018
First decision: June 9, 2018
Revised: September 7, 2018
Accepted: November 3, 2018
Article in press: November 3, 2018
Published online: November 30, 2018
To examine the outcome and prognostic factors for high risk patients with acute lymphoblastic leukemia/lymphoma (ALL/LBL) who underwent allogeneic hematopoietic stem cell transplantation (HCT) at our center during the period of 2010-2017
After due institutional review board approval, patients with high risk ALL/LBL post HCT were identified and included. All records were retrospectively collected. Time to event analysis was calculated from the date of HCT until event of interest or last follow up with Kaplan-Meir means. Cox regression model was used for multivariable analysis calculation.
A total of 69 patients were enrolled and examined with a median age of 21 (14-61). After a median follow up of 15 mo (2-87.3), the 2-year cumulative incidence of relapse, cumulative incidence of non-relapse mortality, progression free survival and overall survival (OS) were 34.1%, 10.9%, 54.9% and 62.8%, respectively. In a multivariable analysis for OS; acute graft vs host disease (GVHD) and chronic GVHD were significant with corresponding hazard ratio 4.9 (1.99-12; P = 0.0007) and 0.29 (0.1-0.67; P = 0.0044), respectively.
Allogeneic-HCT for high risk ALL/LBL resulted in promising remissions particularly for patients with cGVHD.
Core tip: Allogeneic hematopoietic stem cell transplantation (HCT) is a potentially curative therapy for acute lymphoblastic leukemia/lymphoma (ALL/LBL) patients. We examined the outcome and prognostic factors of HCT for high risk ALL/LBL at our center. After due institutional review board approval, 69 patients were enrolled. After a median follow up of 15 mo (2-87.3), the 2-year overall survival (OS) was 62.8%. In a multivariable analysis; acute graft vs host disease (GVHD) and chronic GVHD predicted OS. In conclusion, allogeneic-HCT for ALL/LBL results in promising remissions in high risk disease and early referral for HCT to be considered for young and fit patients.