Hematopoietic Stem Cell Transplantation for Adult Philadelphia-Negative Acute Lymphoblastic Leukemia in the First Complete Remission in the Era of Minimal Residual Disease

Bourlon, Christianne; Lacayo-Leñero, Dennis; Inclán-Alarcón, Sergio I; Demichelis‐Gómez, Roberta

doi:10.1007/s11912-018-0679-9

Cited by 10 publications

(8 citation statements)

References 42 publications

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“…Consistent with previous studies, [ 14 , 16 – 20 , 23 , 25 , 64 ] our study showed that patients with post-MRD + suffered higher CIR and poorer survival than post-MRD − patients. In addition, we also found that post-MRD + at different time points was related to a higher incidence of relapse and a lower probability of LFS and OS, which was consistent with the results of Bader et al .…”

Section: Discussionsupporting

confidence: 93%

A risk score system for stratifying the risk of relapse in B cell acute lymphocytic leukemia patients after allogenic stem cell transplantation

Cao

Zhou

Liu

et al. 2021

Chinese Medical Journal

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Background For patients with B cell acute lymphocytic leukemia (B-ALL) who underwent allogeneic stem cell transplantation (allo-SCT), many variables have been demonstrated to be associated with leukemia relapse. In this study, we attempted to establish a risk score system to predict transplant outcomes more precisely in patients with B-ALL after allo-SCT. Methods A total of 477 patients with B-ALL who underwent allo-SCT at Peking University People's Hospital from December 2010 to December 2015 were enrolled in this retrospective study. We aimed to evaluate the factors associated with transplant outcomes after allo-SCT, and establish a risk score to identify patients with different probabilities of relapse. The univariate and multivariate analyses were performed with the Cox proportional hazards model with time-dependent variables. Results All patients achieved neutrophil engraftment, and 95.4% of patients achieved platelet engraftment. The 5-year cumulative incidence of relapse (CIR), overall survival (OS), leukemia-free survival (LFS), and non-relapse mortality were 20.7%, 70.4%, 65.6%, and 13.9%, respectively. Multivariate analysis showed that patients with positive post-transplantation minimal residual disease (MRD), transplanted beyond the first complete remission (≥CR2), and without chronic graft-versus-host disease (cGVHD) had higher CIR ( P < 0.001, P = 0.004, and P < 0.001, respectively) and worse LFS ( P < 0.001, P = 0.017, and P < 0.001, respectively), and OS ( P < 0.001, P = 0.009, and P < 0.001, respectively) than patients without MRD after transplantation, transplanted in CR1, and with cGVHD. A risk score for predicting relapse was formulated with the three above variables. The 5-year relapse rates were 6.3%, 16.6%, 55.9%, and 81.8% for patients with scores of 0, 1, 2, and 3 ( P < 0.001), respectively, while the 5-year LFS and OS values decreased with increasing risk score. Conclusion This new risk score system might stratify patients with different risks of relapse, which could guide treatment.

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Section: Discussionsupporting

confidence: 93%

A risk score system for stratifying the risk of relapse in B cell acute lymphocytic leukemia patients after allogenic stem cell transplantation

Cao

Zhou

Liu

et al. 2021

Chinese Medical Journal

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“…Residual leukemia cells in patients are the main cause of disease relapse. The OS and PFS for no remission (NR) patients are significantly lower than those for CR patients, and the cumulative relapse rate is also significantly higher than that of remission patients [9,10]. However, even if the patient is in CR status, the MRD may be detected in some patients.…”

Section: Discussionmentioning

confidence: 99%

Impact of pre-transplantation minimal residual disease (MRD) on the outcome of Allogeneic hematopoietic stem cell transplantation for acute leukemia

Shen

Pan

et al. 2021

Hematology

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Objective: To investigate the impact of minimal residual disease (MRD) before allogeneic hematopoietic stem cell transplantation (allo-HSCT) on the outcome of acute leukemia. Methods: Data from 114 patients who were diagnosed with acute leukemia (AL) and underwent allo-HSCT between Jan 2013 and Dec 2019 were collected and analyzed. The patients were attributed into MRD positive (MRD+) group and MRD negative (MRD−) group. Results: Among the 114 acute leukemia patients, there were 32 MRD+ patients before transplantation, and 82 MRD− patients. No significant difference was found between the MRD+ group and the MRD− group in the incidence of acute graft-versus-host disease (aGvHD) (p = 0.09). Compared with the MRD+ group, the MRD− group had a higher incidence of chronic graft-versus-host disease (cGvHD) (p = 0.008). There is no significance in relapse between the two groups (p = 0.084), while the incidence of relapse was seemingly higher in the MRD+ group: 36.9% Vs 19.7% . We attributed to the lack of sample size and NRM in MRD+ group was remarkably higher. The MRD+ group had significantly worse oneyear overall survival (OS) ( , p = 0.003) and one-year progression-free survival (PFS) (, p = 0.009). In the multivariate analysis, MRD+ was an independent prognostic factor for OS (HR = 1.898; 95%CI 1.042-3.457; p = 0.036). Conclusion: Pre-transplantation MRD positive status is a risk factor for survival and prognosis after HSCT. Upon this, emphasis should be put on (1) screening more efficient chemo regimen with targeted agents, to help patients reach and keep MRD− status before transplantation; (2) designing better management with different GvHD prophylaxis treatment, timely disease monitoring and preemptive intervention on relapse.

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“…One of the first immunotherapies used for T cell lymphoma and leukemia is allogeneic stem cell transplantation. In allo-HCT the entire hemopoietic and immune system of the patient is substituted with one derived from an HLA-matched donor(45). This strategy has demonstrated to be the only curative option for a subset of TCL(46-48), however treatment-related mortality and late graft versus host complications could impact long-term quality of life (46-48).…”

Section: Immunotherapeutic Strategies For T Cell Leukemia and Lymphomamentioning

confidence: 99%

Novel Immunotherapies for T Cell Lymphoma and Leukemia

Ghione

Moskowitz

Paola

et al. 2018

Curr Hematol Malig Rep

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Purpose of review: novel immunotherapies such as checkpoint inhibitors, bispecific and chimeric antigen receptor T cells are leading to promising responses when treating solid tumors and hematological malignancies. T cell neoplasms include leukemia and lymphomas that are derived from T cells. These are rare diseases with generally poor clinical outcomes. This review describes the rational and preliminary results of these approaches for people with T cell lymphoma and leukemia. Recent findings: for T cell neoplasms, despite significant research effort, only few agents, such as monoclonal antibodies and allogeneic stem cell transplantation, showed some clinical activity. One of the major hurdles to targeting T cell neoplasms is that activation or elimination of T cells, either normal or neoplastic, can cause significant toxicity. A need to develop novel safe and effective immunotherapies for T cell neoplasms exists. Summary: In this review, we will discuss the rationale for immunotherapy of T cell leukemia and lymphoma and present the most recent therapeutic approaches.

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Hematopoietic Stem Cell Transplantation for Adult Philadelphia-Negative Acute Lymphoblastic Leukemia in the First Complete Remission in the Era of Minimal Residual Disease

Cited by 10 publications

References 42 publications

A risk score system for stratifying the risk of relapse in B cell acute lymphocytic leukemia patients after allogenic stem cell transplantation

A risk score system for stratifying the risk of relapse in B cell acute lymphocytic leukemia patients after allogenic stem cell transplantation

Impact of pre-transplantation minimal residual disease (MRD) on the outcome of Allogeneic hematopoietic stem cell transplantation for acute leukemia

Novel Immunotherapies for T Cell Lymphoma and Leukemia

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