| Title | Comparison of central nervous system relapse outcomes following haploidentical vs identical-sibling transplant for acute lymphoblastic leukemia |
| Authors | Chen, Qi Zhao, Xin Fu, Hai-xia Chen, Vu-hong Zhang, Yuan-yuan Wang, Jing-zhi Wang, Yu Yan, Chen-hua Wang, Feng-rong Mo, Xiao-dong Han, Wei Chen, Huan Chang, Ying-jun Xu, Lan-ping Liu, Kai-yan Huang, Xiao-jun Zhang, Xiao-hui |
| Affiliation | Peking Univ, Peoples Hosp, 11 Xizhimen South St, Beijing, Peoples R China Peking Univ, Inst Hematol, Beijing, Peoples R China Natl Clin Res Ctr Hematol Dis, Beijing, Peoples R China Beijing Key Lab Hematopoiet Stem Cell Transplanta, Beijing, Peoples R China |
| Keywords | STEM-CELL TRANSPLANTATION BONE-MARROW-TRANSPLANTATION ACUTE MYELOID-LEUKEMIA UNRELATED CORD BLOOD HIGH-RISK EXTRAMEDULLARY RELAPSE MISMATCHED HLA ADULTS CHEMOTHERAPY MULTICENTER |
| Issue Date | Jul-2020 |
| Publisher | ANNALS OF HEMATOLOGY |
| Abstract | To explore the incidence, risk factors, and outcomes of central nervous system (CNS) relapse after allogeneic hematopoietic stem cell transplantation (allo-HSCT) for acute lymphoblastic leukemia (ALL) and to compare the differences in CNS relapse between haploidentical donor HSCT (HID-HSCT) and HLA-identical sibling donor HSCT (ISD-HSCT). We performed a retrospective nested case-control study on patients with CNS relapse after allo-HSCT. The cumulative incidence of CNS relapse was 4.06% after allo-HSCT in ALL, with a significantly poor prognosis. The incidence was 3.91% and 5.36% in HID-HSCT and ISD-HSCT, respectively (p = .227). Among the patients with CNS relapse, the overall survival (OS) at 3 years was 56.2 +/- 6.8% in the HID-HSCT subgroup and 76.9 +/- 10.2% in the ISD-HSCT subgroup (p = .176). The 3-year cumulative incidence of systemic relapse was also comparable between the two subgroups (HID-HSCT, 40.6 +/- 7.4%; ISD-HSCT, 13.3 +/- 8.7%, respectively,p = .085). Younger age (p = .045), T-ALL (p = .035), hyperleukocytosis at diagnosis (p < .001), advanced disease stage at transplant (p < .001), pre-HSCT CNS involvement (p < .001), and absence of chronic graft vs host disease (cGVHD) (p < .001) were independent risk factors for CNS relapse after allo-HSCT. In conclusion, CNS relapse was a significant complication after allo-HSCT in ALL and was associated with poor prognosis. The incidences and outcomes were comparable between HID-HSCT and ISD-HSCT. |
| URI | http://hdl.handle.net/20.500.11897/590102 |
| ISSN | 0939-5555 |
| DOI | 10.1007/s00277-020-04080-9 |
| Indexed | SCI(E) |
| Appears in Collections: | 人民医院 |
