Poorer Allogeneic HCT Outcomes for Adolescents and Young Adults with B-ALL

Share this content:
(ChemotherapyAdvisor) – Patients with precursor B-cell acute lymphoblastic leukemia (B-ALL) who undergo myeloablative allogeneic hematopoietic cell transplantation (allo-HCT) after age 13 years have higher rates of transplant-related mortality (TRM) and lower survival rates than do younger patients, according to a retrospective single-institution study published in Biology of Blood and Marrow Transplantation.

Adolescent and young adult patients with B-ALL have “significantly inferior OS [overall survival] compared to children due to greater TRM,” reported a team led by Michael J. Burke, MD, at the University of Minnesota's Pediatrics Division of Hematology/Oncology, in Minneapolis, Minnesota.

“(T)he allotransplant graft-versus-leukemia effect mediated relapse protection and provide rationale for investigations to identify new pre-transplant risk factors that may allocate older-age patients to allo-HCT in CR1 or CR2, rather than CR3 where outcomes are found to be significantly worse.”

Age ≥13 years at diagnosis is a high-risk factor for patients with B-ALL, but the role of age at time of transplant on outcome is not known. The authors reviewed allo-HCT outcomes among 136 patients who had been diagnosed at between ages 0 and 30 years, 79 (58%) of whom were age <13 years and 57 (42%) of whom were age 13 to 30 years.

Patients <13 years of age at allo-HCT had superior 5-year OS compared to adolescents and young adults (62% vs. 39%; P=0.03; Hazard Ratio [HR]=1.74; 95% CI, 1.04-2.95;P=0.03). In multivariate analyses, cumulative TRM at 1-year was higher among adolescents and young adults compared to children <13 years of age (28% vs. 14%; P=0.04). A trend was also identified between older age and higher TRM incidence (Risk Ratio [RR]=2.23; 95% CI, 1.01-4.9, P=0.05).

Graft source (marrow vs. umbilical cord blood), gender, and graft-versus-host disease status did not associate with TRM.

“Further improvements in peri-transplant care are needed to limit complications” in adolescent and young adult patients receiving allo-HCT for B-ALL, the authors wrote.


Related Resources

You must be a registered member of Cancer Therapy Advisor to post a comment.

Sign Up for Free e-newsletters

Regimen and Drug Listings


Bone Cancer Regimens Drugs
Brain Cancer Regimens Drugs
Breast Cancer Regimens Drugs
Endocrine Cancer Regimens Drugs
Gastrointestinal Cancer Regimens Drugs
Gynecologic Cancer Regimens Drugs
Head and Neck Cancer Regimens Drugs
Hematologic Cancer Regimens Drugs
Lung Cancer Regimens Drugs
Other Cancers Regimens
Prostate Cancer Regimens Drugs
Rare Cancers Regimens
Renal Cell Carcinoma Regimens Drugs
Skin Cancer Regimens Drugs
Urologic Cancers Regimens Drugs