PO-05. Outcomes of allogeneic hematopoietic stem cell transplantation for children, adolescents, young adults with acute lymphoblastic leukemia at the Center for Pediatric Oncology, Hematology and Immunology
Dmitry V. Prudnikov, Natalia P. Kirsanova, Yulia E. Mareiko, Olha A. Mishkova, Aleksey V. Alekseychik, Mariya G. Naumovich, Nina V. Minakovskaya
Belarusian Research Center for Pediatric Oncology, Hematology and Immunology, Minsk, Republic of Belarus
Contact: Dr. Dmitry V. Prudnikov, phone: +37517 265-48-51, e-mail: email@example.com
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains an important treatment option for patients with acute lymphoblastic leukemia (ALL). The results of allo-HSCT in children with ALL have significantly improved in the last decade. This study is aimed to evaluate the results of allo-HSCT in children, adolescents, and young adults with ALL at the Republican Scientific and Practical Center for Pediatric Oncology, Hematology, and Immunology.
Materials and methods
The study included 106 patients (75 children and 31 young adults; males, 59%) with ALL who received allo-HSCT at the Center for Pediatric Oncology, Hematology, and Immunology from 2001 to 2020. HLA-related, unrelated and haploidentical donors were used in 33, 59 and 8% of cases, respectively. Acute graft-versus-host disease (GVHD) was registered in 57 cases (54%); chronic GVHD, in 36 patients (34%). The Kaplan-Meier method was used to evaluate overall survival (OS), event-free survival (EFS), and GVHD and relapse-free survival (GRFS). In single-factor analysis survival was compared by Logrank test. The cumulative incidence of relapse (CIR) and death after allo-HSCT without recurrence (NRM) were calculated by the method of competing risks using Gray’s test. The results were evaluated and compared over two consecutive 10-year periods (2001-2010 and 2011-2020). The data was censored at 01.07.2022.
The 3-year OS and EFS were, respectively, 42.5±7.8% and 40.0±7.8% for the first (n=40) and 76.7±5.3% (p<0.001), 68.1±5.8% (p<0.001) for the second (n=66) follow-up periods. The 3-year GRFS was 57.1±6.1% and 27.5±7.1%, respectively (p<0.001). The 3-year NRM rate over 2011-2020 was 9.2±3.6% (p<0.001), and CIR was 21.2±5.1% (p=0.60). There were no differences for aGVHD and cGVHD incidence between the both studied periods. The OS, EFS, and GRFS did not show statistically significant changes from 2001 to 2020 depending on donor type (related, unrelated or haploidentical), or age of the recipient (<4 years, 4-17, and >18 years). However, 3-year CIR in recipients <4 years (n=7) was 57.1±21.1% (p=0.01).
Thus, the outcomes of HSCT in children, adolescents, and young adults with ALL remain good when using traditional approaches. Development and implementation of cell therapy methods with their subsequent use in the treatment of children with ALL, and the active usage of transplantation from a haploidentical donor with appropriate support will further improve allo-HSCT parameters in children with ALL.
Hematopoietic stem cell transplantation, acute lymphoblastic leukemia, children.