Outcomes of allogeneic or autologous stem cell transplantation followed by maintenance chemotherapy in adult patient with B‐ALL in CR1 with no detectable minimal residual disease

Abstract

Adult acute lymphoblastic leukaemia (ALL) is one of the most prevalent haematological malignancies in adults, accounting for about 20-30% of cases. The complete remission (CR) rate can reach 70-90% but more than 60% of patients still relapse when treated with intensive consolidation chemotherapies. Consequently, allogeneic haematopoietic stem cell transplantation (allo-HSCT) is considered the standard care for postremission treatment to reduce the risk of recurrence, albeit accompanied by high therapy-related mortality (TRM). 1,2 In recent years, superior results have been achieved in B cell-ALL (B-ALL) therapy and the role of allo-HSCT in first CR (CR1) patients is an area of active investigation. Recently, the emergence and rapid development of novel targeted therapies in B-ALL, including monoclonal antibodies against specific tumour antigens (inotuzumab, blinatumomab, etc.) and chimeric antigen receptor T cells characterized by a high response rate and acceptable tolerance, have been witnessed. [3][4][5] For adolescents and young adults, paediatric-inspired protocols may achieve comparable or even potentially better results without upfront allo-HSCT. 6 In Philadelphia chromosome-positive

The outcome of acute leukemia patients with SET-NUP214 fusion after allogeneic stem cell transplantation

“…All 11 patients received myeloablative conditioning and allogeneic stem cell transplantation. The conditioning regimens for patients with AML were as follows: four patients with AML received conditioning regimens consisting of Busulfan (Bu, 3.2 mg/ kg, days -9 to -7), Cyclophosphamide (Cy, 40 mg/kg, days -3 to -2), and Cytarabine(Ara-C, 2 g/m 2 , days -6 to -4) or Idarubicin (IDA, Cycles of chemotherapy to achieve CR1 (7). One patient with T-ALL received etoposide instead of fludarabine and cytarabine.…”

“…ATG was also given to the patient who was older than 40 years old (n=1). Calcineurin inhibitors plus short-term methotrexate along with or without mycophenolate mofetil were used for acute graft versus host disease prophylaxis as previously described (7,8). Three patients received stem cells from matchedsibling donors, six from related haploidentical donors, and two from matched unrelated donors.…”