Prognostic factors of children and adolescents with T-cell acute lymphoblastic leukemia after allogeneic transplantation.

Adolescent Adult Child Graft vs Host Disease / complications Hematopoietic Stem Cell Transplantation / methods Humans Precursor Cell Lymphoblastic Leukemia-Lymphoma / etiology Precursor T-Cell Lymphoblastic Leukemia-Lymphoma / therapy Prognosis Recurrence Retrospective Studies T-Lymphocytes Transplantation Conditioning / methods Transplantation, Homologous Young Adult

adolescent child graft versus host disease lymphoid leukemia stem cell transplantation

Journal

Hematological oncology

ISSN: 1099-1069

Titre abrégé: Hematol Oncol

Pays: England

ID NLM: 8307268

Informations de publication

Date de publication:
Aug 2022

Historique:

revised: 24 01 2022

received: 12 12 2021

accepted: 18 02 2022

pubmed: 26 2 2022

medline: 10 8 2022

entrez: 25 2 2022

Statut: ppublish

Résumé

Acute lymphoblastic leukemia (ALL) is the most common cancer during childhood, and some high-risk patients with ALL require hematopoietic stem cell transplantation (HSCT). Mainly due to small patient numbers, studies focusing specifically on children and adolescents with T-cell ALL (T-ALL) are limited. Using a nationwide registry, we retrospectively analyzed data from patients under 20 years old who underwent their first HSCT for T-ALL between 2000 and 2018. As a result, total 484 patients were included, and their median follow-up period was 6.9 years after HSCT for survivors. While patients receiving HSCT at first complete remission (CR) showed relatively good 5-year leukemia free survival (5yLFS, 73.5%), once relapse occurred, their prognosis was much worse (44.4%) even if they attained second remission again (p < 0.001). Among patients receiving HSCT at CR1, grade II-IV acute graft versus host disease was associated with worse overall and LFS than grade 0-I (5yLFS 69.5% vs. 82.1%, p = 0.026) mainly due to high non-relapse mortality. Among those patients, patients receiving related bone marrow transplantation, unrelated bone marrow transplantation, or unrelated cord blood transplantation showed similar survival (5yLFS, 73.2%, 76.3%, and 77.0%, respectively). For patients undergoing cord blood transplantation at CR1, total-body irradiation-based myeloablative conditioning was associated with better 5yLFS than other conditioning regimens (85.4% vs. 62.2%, p = 0.044), as it reduced the risk of relapse. These results indicate that relapsed patients have much less chance of cure, and that identifying patients who require HSCT for cure and offering them HSCT with optimal settings during CR1 are crucial for children and adolescents with T-ALL.

Identifiants

DOI: 10.1002/hon.2980 PMID: 35212019

pubmed: 35212019

doi: 10.1002/hon.2980

doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

Pagination

457-468

Informations de copyright

Références

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