TY - JOUR
T1 - Outcomes and Prognostic Factors for Patients with Relapsed or Refractory Acute Lymphoblastic Leukemia Who Underwent Allogeneic Hematopoietic Cell Transplantation
T2 - A KSGCT Multicenter Analysis
AU - Kanto Study Group for Cell Therapy (KSGCT)
AU - Tachibana, Takayoshi
AU - Kanda, Junya
AU - Ishizaki, Takuma
AU - Najima, Yuho
AU - Tanaka, Masatsugu
AU - Doki, Noriko
AU - Fujiwara, Shin ichiro
AU - Kimura, Shun ichi
AU - Onizuka, Makoto
AU - Takahashi, Satoshi
AU - Saito, Takeshi
AU - Mori, Takehiko
AU - Fujisawa, Shin
AU - Sakaida, Emiko
AU - Matsumoto, Kenji
AU - Aotsuka, Nobuyuki
AU - Gotoh, Moritaka
AU - Watanabe, Reiko
AU - Shono, Katsuhiro
AU - Usuki, Kensuke
AU - Tsukada, Nobuhiro
AU - Kanamori, Heiwa
AU - Kanda, Yoshinobu
AU - Okamoto, Shinichiro
N1 - Funding Information:
Conflict of interest statement: K.U. has received grants and personal fees from MSD, Sumitomo Dainippon Pharma, Pfizer Japan, and Celgene; grants from Astellas Pharma, Otsuka, Kyowa Kirin, GlaxoSmithKline, Sanofi, Shire Japan, SymBio Pharmaceuticals, Daiichi Sankyo, Boehringer-Ingelheim Japan, and Janssen Pharmaceutical; and personal fees from Novartis, Ono Pharmaceutical, Takeda Pharmaceuticals, Chugai Pharmaceutical, Nippon Shinyaku, and Mochida Pharmaceutical. The other authors have no conflicts of interest to report.
PY - 2020/5
Y1 - 2020/5
N2 - A multicenter retrospective study was performed to evaluate the prognostic factors in 104 patients with relapsed or refractory acute lymphoblastic leukemia (ALL), who underwent allogeneic hematopoietic cell transplantation (HCT) between 2005 and 2015. The median age was 38 (range, 17 to 68), and the median blast fraction in peripheral blood and bone marrow was 1% (range, 0 to 99%) and 52% (range, 0 to 100%), respectively. With a median follow-up of 47 months (range, 8.3 to 105 months), overall survival (OS), nonrelapse mortality, and relapse mortality at 1 year were 25%, 44%, and 31%, respectively. Multivariate analysis demonstrated independent predictors for poor OS, including nuclear cell count in the bone marrow ≥10 × 104/μL (hazard ratio [HR], 2.14; 95% confidence interval [CI], 1.33 to 3.43; P = .002), elevated lactate dehydrogenase level (HR, 1.66; 95% CI, 1.05 to 2.62; P = .031), and no primary induction failure (HR, 2.05; 95% CI, 1.11 to 3.78; P = .022). A prognostic scoring index was designed based on these survival predictors. At 2 years, OS was 28%, 14%, and 0% for good (score 0 or 1; n = 47), intermediate (score 2; n = 40), and poor (score 3; n = 17), respectively (P < .001). This scoring system may be useful in identifying the patient population for which allogeneic HCT is least beneficial in advanced stages of ALL.
AB - A multicenter retrospective study was performed to evaluate the prognostic factors in 104 patients with relapsed or refractory acute lymphoblastic leukemia (ALL), who underwent allogeneic hematopoietic cell transplantation (HCT) between 2005 and 2015. The median age was 38 (range, 17 to 68), and the median blast fraction in peripheral blood and bone marrow was 1% (range, 0 to 99%) and 52% (range, 0 to 100%), respectively. With a median follow-up of 47 months (range, 8.3 to 105 months), overall survival (OS), nonrelapse mortality, and relapse mortality at 1 year were 25%, 44%, and 31%, respectively. Multivariate analysis demonstrated independent predictors for poor OS, including nuclear cell count in the bone marrow ≥10 × 104/μL (hazard ratio [HR], 2.14; 95% confidence interval [CI], 1.33 to 3.43; P = .002), elevated lactate dehydrogenase level (HR, 1.66; 95% CI, 1.05 to 2.62; P = .031), and no primary induction failure (HR, 2.05; 95% CI, 1.11 to 3.78; P = .022). A prognostic scoring index was designed based on these survival predictors. At 2 years, OS was 28%, 14%, and 0% for good (score 0 or 1; n = 47), intermediate (score 2; n = 40), and poor (score 3; n = 17), respectively (P < .001). This scoring system may be useful in identifying the patient population for which allogeneic HCT is least beneficial in advanced stages of ALL.
KW - Acute lymphoblastic leukemia
KW - Allogeneic hematopoietic cell transplantation
KW - Nuclear cell count
KW - Prognostic factors
KW - Relapsed and refractory
KW - Scoring index
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UR - http://www.scopus.com/inward/citedby.url?scp=85079515871&partnerID=8YFLogxK
U2 - 10.1016/j.bbmt.2020.01.007
DO - 10.1016/j.bbmt.2020.01.007
M3 - Article
C2 - 31962165
AN - SCOPUS:85079515871
VL - 26
SP - 998
EP - 1004
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
SN - 1083-8791
IS - 5
ER -