Autologous versus allogeneic hematopoietic cell transplantation for older patients with acute lymphoblastic leukemia. An analysis from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation

Allogeneic hematopoietic cell transplantation (allo-HCT) with reduced intensity conditioning (RIC) is an option for elderly patients with acute lymphoblastic leukemia (ALL). We retrospectively compared results of RIC-allo-HCT from either a matched sibling donor (MSD, n  = 209) or matched unrelated d...

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Published in:Bone marrow transplantation (Basingstoke) 2023-04, Vol.58 (4), p.393-400
Main Authors: Giebel, Sebastian, Labopin, Myriam, Houhou, Mohamed, Caillot, Denis, Finke, Jürgen, Blaise, Didier, Fegueux, Nathalie, Ethell, Mark, Cornelissen, Jan J., Forcade, Edouard, Yakoub-Agha, Ibrahim, Lussana, Federico, Maertens, Johan, Bourhis, Jean Henri, Jindra, Pavel, Gorin, Norbert Claude, Nagler, Arnon, Mohty, Mohamad
Format: Article
Language:English
Subjects:
692/699/1541/1990/283/2125
692/700/565/2319
Acute Disease
Acute lymphoblastic leukemia
Aged
Allografts
Autografts
Bone Marrow
Bone marrow transplantation
Cell Biology
Clinical trials
Graft vs Host Disease - etiology
Hematology
Hematopoietic Stem Cell Transplantation - methods
Hematopoietic stem cells
Humans
Internal Medicine
Leukemia
Leukemia, Myeloid, Acute - therapy
Life Sciences
Lymphatic leukemia
Medicine
Medicine & Public Health
Mud
Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy
Prospective Studies
Public Health
Recurrence
Remission
Retrospective Studies
Stem cell transplantation
Stem Cells
Survival
Transplantation
Transplantation Conditioning - methods
Transplantation, Homologous - methods
Transplants & implants
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Summary:Allogeneic hematopoietic cell transplantation (allo-HCT) with reduced intensity conditioning (RIC) is an option for elderly patients with acute lymphoblastic leukemia (ALL). We retrospectively compared results of RIC-allo-HCT from either a matched sibling donor (MSD, n  = 209) or matched unrelated donor (MUD, n  = 209) with autologous (auto, n  = 142) HCT for patients aged 55 years or more treated in first complete remission (CR1) between 2000 and 2018. The probabilities of leukemia-free survival (LFS) at 5 years were 34% for RIC-allo-HCT versus 39% for auto-HCT ( p  = 0.11) while overall survival (OS) rates were 42% versus 45% ( p  = 0.23), respectively. The incidence of relapse (RI) and non-relapse mortality (NRM) was 41% versus 51% ( p  = 0.22) and 25% versus 10% ( p  = 0.001), respectively. In a multivariate model, using auto-HCT as reference, the risk of NRM was increased for MSD-HCT (Hazard ratio [HR] = 2.1, p  = 0.02) and MUD-HCT (HR = 3.08, p  
ISSN:0268-3369
1476-5365
DOI:10.1038/s41409-022-01904-2