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Long-term survival outcomes in patients with ALL who were alive and disease-free 2 years after allo-HSCT
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Although most deaths following allo-HSCT occur in the first 2 years post transplantation, long-term survivors are still at risk of late complications.1 A large, multicenter, retrospective, EBMT registry-based study assessed long-term survival and prognostic factors of late relapse in adult patients with acute leukemia who were alive and disease-free at 2 years after allo-HSCT. This analysis included 2,701 patients with ALL who underwent allo-HSCT between 2005 and 2012. Results were published in Hemasphere by Larue et al.1 |
| Key learnings |
| The 10-year probability for OS and LFS was 81.3% and 78.2%, respectively. |
| The cumulative RI and NRM at 10 years was 9.9% and 11.9%, respectively, and the probability of cGRFS at 10 years was 73.3%. |
| Patient- and disease-specific factors: Older age, transplantation in second or third CR, and advanced disease were associated with worse survival outcomes. |
| Transplant-specific factors: Transplantation from UD vs MSD, and PB grafts vs BM grafts were associated with inferior survival outcomes. The use of ATG improved OS, LFS, and NRM. |
| Relapses (31.9%) and cGvHD (27.3%) were the most common cause of late mortality. |
| These findings underscore the importance of optimizing pre-transplant strategies and the need for targeted interventions and surveillance strategies in long-term survivorship care to reduce late complications and improve survival outcomes. |
Abbreviations: ALL, acute lymphoblastic leukemia; allo-HSCT, allogeneic hematopoietic stem cell transplantation; ATG, antithymocyte globulin; BM, bone marrow; cGRFS, composite of chronic graft‐versus‐host disease‐free and relapse‐free survival; cGvHD, chronic graft-versus-host disease; CR, complete remission; EBMT, European Society for Blood and Marrow Transplantation; LFS, leukemia-free survival; MSD, matched sibling donor; NRM, non-relapse mortality; OS, overall survival; PB, peripheral blood; RI, relapse incidence; UD, unrelated donor.
- Larue M, Labopin M, Schroeder T, et al. Long-term outcome of 2-year survivors after allogeneic hematopoietic cell transplantation for acute leukemia. 2024;8(10):e70026. DOI: 10.1002/hem3.70026
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