The all Hub website uses a third-party service provided by Google that dynamically translates web content. Translations are machine generated, so may not be an exact or complete translation, and the all Hub cannot guarantee the accuracy of translated content. The all and its employees will not be liable for any direct, indirect, or consequential damages (even if foreseeable) resulting from use of the Google Translate feature. For further support with Google Translate, visit Google Translate Help.
The ALL Hub is an independent medical education platform, sponsored by Jazz Pharmaceuticals, Amgen, and Pfizer and supported through an educational grant from the Hippocrate Conference Institute, an association of the Servier Group. The funders are allowed no direct influence on our content. The levels of sponsorship listed are reflective of the amount of funding given. View funders.
Now you can support HCPs in making informed decisions for their patients
Your contribution helps us continuously deliver expertly curated content to HCPs worldwide. You will also have the opportunity to make a content suggestion for consideration and receive updates on the impact contributions are making to our content.
Find out more
Create an account and access these new features:
Bookmark content to read later
Select your specific areas of interest
View all content recommended for you
Role of allo-HSCT in patients with Ph-like ALL in first complete remission
|
Ph-like ALL is a high-risk subset of B-ALL associated with poor treatment response rates and high relapse rates.1 Although allo-HSCT is often recommended for these patients, positive evidence is limited to small, single-center studies.1 A large, multicenter, retrospective analysis assessed the benefit of allo-HSCT in adult patients with Ph-like ALL (n = 83) in CR1 compared to patients with Ph+ ALL (n = 271) and other subsets of Ph− B-ALL (n = 319).1 Results from this analysis were published in Transplantation and Cellular Therapy by Rahman et al.1 |
| Key learnings |
| Patients with Ph-like ALL undergoing allo-HSCT in CR1 had similar outcomes to other Ph− ALL subtypes, with comparable 3-year OS (66% vs 59%; p = 0.3), PFS (59% vs 54%; p = 0.4), and relapse rates (20% vs 22%; p = 0.7). |
| Patients with Ph-like ALL had worse outcomes compared to patients with Ph+ ALL, with lower 3-year OS (66% vs 75%; p < 0.001), PFS (59% vs 70%; p = 0.001), and higher 3-year relapse rates (20% vs 12%; p = 0.003), possibly due to the benefits of pre- and post-transplantation TKI therapy. |
| Multivariate analysis demonstrated that, while Ph+ ALL was associated with lower relapse rates (HR, 0.4; 95% CI, 0.3–0.7; p <0.001), MRD positivity prior to allo-HSCT was associated with increased relapse rates (HR, 2.9; 95% CI, 1.8–4.7; p <0.001); this highlights the utility of MRD as a prognostic indicator. |
| These findings suggest that allo-HSCT, combined with targeted second-line therapies, has the potential to improve the historically poor prognosis of patients with Ph-like ALL and achieve survival outcomes comparable to patients with other Ph− ALL subtypes. |
Abbreviations: ALL, acute lymphoblastic leukemia; allo-HSCT, allogeneic hematopoietic cell transplantation; B-ALL, B-cell ALL; CI, confidence interval; CR1, first complete remission; HR, hazard ratio; MRD, measurable residual disease; OS, overall survival; PFS, progression-free survival; PH, Philadelphia-chromosome; TKI, tyrosine kinase inhibitor.
References
Please indicate your level of agreement with the following statements:
The content was clear and easy to understand
The content addressed the learning objectives
The content was relevant to my practice
I will change my clinical practice as a result of this content
