TY - JOUR
T1 - A Multicenter Analysis of Allogeneic Transplant Outcomes in Adults with Philadelphia-Like B-Cell Acute Lymphoblastic Leukemia in First Complete Remission
AU - Rahman, Zaid Abdel
AU - Othman, Tamer
AU - Saliba, Rima M.
AU - Vanegas, Yenny Alejandra Moreno
AU - Mohty, Razan
AU - Ledesma, Celina
AU - Rondon, Gabriela
AU - Jain, Nitin
AU - Jabbour, Elias
AU - Pullarkat, Vinod
AU - Alkhateeb, Hassan B.
AU - Kantarjian, Hagop M.
AU - Greipp, Patricia T.
AU - Nakamura, Ryotaro
AU - Kharfan-Dabaja, Mohamed A.
AU - Champlin, Richard E.
AU - Forman, Stephen J.
AU - Shpall, Elizabeth J.
AU - Litzow, Mark R.
AU - Foran, James M.
AU - Aldoss, Ibrahim
AU - Koller, Paul B.
AU - Kebriaei, Partow
N1 - Publisher Copyright:
© 2024 The American Society for Transplantation and Cellular Therapy
PY - 2024/12
Y1 - 2024/12
N2 - Philadelphia-like acute lymphoblastic leukemia (Ph-like ALL) is a high-risk subset of B-cell ALL with a poor prognosis with conventional therapies. Diagnostic challenges and lack of standardized treatment protocols contribute to suboptimal outcomes. Additionally, while allogeneic hematopoietic cell transplantation (HCT) is frequently recommended in adults with Ph-like ALL given its high-risk nature, data supporting its role remains limited. We conducted a multicenter retrospective study evaluating outcomes of adult patients undergoing HCT in first complete remission (CR1) for Ph-like ALL compared to Philadelphia chromosome positive ALL (Ph-pos) and other B-cell Philadelphia negative (Ph-neg) ALL. Data was collected from five academic centers across the US, focusing on HCT outcomes for patients with ALL. Patients undergoing HCT in CR1 between 2006 and 2021 were included. Among 673 patients, 83 (12.3%) had Ph-like ALL, while 271 (40.3%) had Ph-pos and 319 (47.4%) had Ph-neg ALL. Outcomes following HCT in CR1 for Ph-like ALL were comparable to Ph-neg ALL, with no significant differences in 3-year overall survival (66% vs. 59%, P =.1), progression-free survival (59% and 54%, P =.1), or relapse rates (22% vs. 20%, P =.7). In contrast, Ph-pos ALL had superior outcomes; 3-year OS (75%, P <.001), PFS (70%, P =.001) and relapse (12%, P =.003), this is likely attributed to tyrosine kinase inhibitor therapy. Our study suggests that HCT, coupled with effective 2nd line therapies can possibly mitigate the poor prognosis associated with Ph-like ALL and offers promising outcomes for patients with Ph-like ALL.
AB - Philadelphia-like acute lymphoblastic leukemia (Ph-like ALL) is a high-risk subset of B-cell ALL with a poor prognosis with conventional therapies. Diagnostic challenges and lack of standardized treatment protocols contribute to suboptimal outcomes. Additionally, while allogeneic hematopoietic cell transplantation (HCT) is frequently recommended in adults with Ph-like ALL given its high-risk nature, data supporting its role remains limited. We conducted a multicenter retrospective study evaluating outcomes of adult patients undergoing HCT in first complete remission (CR1) for Ph-like ALL compared to Philadelphia chromosome positive ALL (Ph-pos) and other B-cell Philadelphia negative (Ph-neg) ALL. Data was collected from five academic centers across the US, focusing on HCT outcomes for patients with ALL. Patients undergoing HCT in CR1 between 2006 and 2021 were included. Among 673 patients, 83 (12.3%) had Ph-like ALL, while 271 (40.3%) had Ph-pos and 319 (47.4%) had Ph-neg ALL. Outcomes following HCT in CR1 for Ph-like ALL were comparable to Ph-neg ALL, with no significant differences in 3-year overall survival (66% vs. 59%, P =.1), progression-free survival (59% and 54%, P =.1), or relapse rates (22% vs. 20%, P =.7). In contrast, Ph-pos ALL had superior outcomes; 3-year OS (75%, P <.001), PFS (70%, P =.001) and relapse (12%, P =.003), this is likely attributed to tyrosine kinase inhibitor therapy. Our study suggests that HCT, coupled with effective 2nd line therapies can possibly mitigate the poor prognosis associated with Ph-like ALL and offers promising outcomes for patients with Ph-like ALL.
KW - ALL
KW - HCT
KW - MRD
KW - Philadelphia-like
UR - http://www.scopus.com/inward/record.url?scp=85206670265&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85206670265&partnerID=8YFLogxK
U2 - 10.1016/j.jtct.2024.09.020
DO - 10.1016/j.jtct.2024.09.020
M3 - Article
C2 - 39332807
AN - SCOPUS:85206670265
SN - 2666-6375
VL - 30
SP - 1197
EP - 1205
JO - Transplantation and Cellular Therapy
JF - Transplantation and Cellular Therapy
IS - 12
ER -