Outcomes have improved during the past decade for patients with acute lymphoblastic leukemia (ALL) who undergo haploidentical hematopoietic cell transplantation (haplo-HCT), according to the results of a retrospective cohort study published in Cancer.
The cohort included patients with ALL who underwent haplo-HCT from 2011 to 2018 and for whom posttransplantation cyclophosphamide (PTCy) was used for graft-vs-host disease (GVHD) prophylaxis.
Patients were identified using the Acute Leukemia Working Party (ALWP) of the European Society for Blood and Marrow Transplantation (EBMT) registry and grouped as receiving transplantation between 2011 and 2015 (early transplantation) or 2016 and 2018 (later transplantation). Outcomes between groups were compared.
A total of 195 patients were identified, 79 had transplantation from 2011 to 2015 and 116 had transplantation from 2016 to 2018.
According to a multivariate analysis, patients in the later transplantation group had a 56% lower risk of nonrelapse mortality (NRM) compared with patients in the earlier transplantation group (hazard ratio [HR]=0.44; 95% CI, 0.22-0.89; P =.022).
Also, the later transplantation group had a prolonged overall survival (OS) compared with the earlier transplantation group (HR=0.47; 95% CI, 0.26-0.86; P =.014) and superior 2-year OS rate (75% vs 53%).
No significant differences were seen between the later transplantation group and earlier transplantation group for relapse incidence, leukemia-free survival, GVDH-free/relapse-free survival, chronic GVHD, and grade 2 through 4 acute GVHD, as shown by multivariate analysis.
“Our analysis indicates that, over the past decade, a significant improvement in patient outcome has been realized in patients with ALL who undergo haplo-HCT using PTCy,” the study authors concluded.
Disclosures: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ affiliations.
Nagler A, Labopin M, Koc Y, et al. Outcome of T-cell-replete haploidentical stem cell transplantation improves with time in adults with acute lymphoblastic leukemia: a study from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation. Cancer. Published online March 19, 2021. doi:10.1002/cncr.33522