Allo-HCT for Ph+ ALL Patients in CR1 with CMR

Ghobadi A, Slade M, Kantarjian HM, et al. The Role of Allogeneic Transplant for Adult Ph+ ALL in CR1 with Complete Molecular Remission: A Retrospective Analysis. Blood. 2022; (doi: 10.1182/blood.2022016194).

A retrospective analysis of allogeneic transplant in first remission determined the procedure did not increase survival for patients with Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL) who achieve complete molecular remission (CMR). The multicenter U.S. study included adult Ph+ ALL patients who underwent induction therapy including tyrosine kinase inhibitors and achieved CMR within 90 days of diagnosis. A total of 230 patients identified, including 98 allogeneic hematopoietic cell transplantation (allo-HCT) recipients and 132 non-HCT patients. The former group skewed younger and had better performance status. Compared with non-HCT treatment, allo-HCT did not correlate with improved overall survival or relapse-free survival. Allo-HCT corresponded with lower cumulative relapse incidence and higher non-relapse mortality. The differences between reduced-intensity HCT and non-HCT across all endpoints were not statistically significant.
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