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Allogeneic HSCT in CR2 for AYAs with ALL: A dual-center study
Results from a dual-center, retrospective study assessing outcomes in 164 adolescents and young adults (AYAs) aged 15–40 years with acute lymphoblastic leukemia (ALL) who underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT) in second complete remission (CR2) between 2010 and 2022 were recently published in the American Journal of Hematology by Pasvolsky et al.
Key data: At median follow-up of 36 months, 3-year overall survival (OS) and progression-free survival (PFS) were 53% and 46%, respectively. The 3-year cumulative incidences of relapse and non relapse mortality (NRM) were 36% and 18%, respectively. Allo-HSCT-specific comorbidity index >3 was independently associated with inferior OS, PFS, and higher NRM. Measurable residual disease (MRD) positivity predicted worse PFS (hazard ratio [HR], 2.7; 95% confidence interval [CI], 1.5–4.8; p < 0.001) and higher relapse risk (HR, 2.8; 95% CI, 1.4–5.6; p = 0.004) but not OS.
Key learning: Allo-HSCT in CR2 remains a curative option for AYA patients with ALL, with outcomes influenced by pretransplant MRD status and comorbidities, supporting the need for risk-adapted transplant strategies.
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