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Allogeneic hematopoietic cell transplantation is equally effective in secondary acute lymphoblastic leukemia (ALL) compared to de-novo ALL—a report from the EBMT registry

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Abstract

Secondary acute lymphoblastic leukemia (s-ALL) comprises up to 10% of ALL patients. However, data regarding s-ALL outcomes is limited. To answer what is the role of allogeneic hematopoietic cell transplantation (HCT) in s-ALL, a matched-pair analysis in a 1:2 ratio was conducted to compare outcomes between s-ALL and de novo ALL (dn-ALL) patients reported between 2000–2021 to the European Society for Blood and Marrow Transplantation registry. Among 9720 ALL patients, 351 (3.6%) were s-ALL, of which 80 were in first complete remission (CR1) with a known precedent primary diagnosis 58.8% solid tumor (ST), 41.2% hematological diseases (HD). The estimated 2-year relapse incidence (RI) was 19.1% (95%CI: 11–28.9), leukemia-free survival (LFS) 52.1% (95%CI: 39.6–63.2), non-relapse mortality (NRM) 28.8% (95%CI: 18.4–40), GvHD-free, relapse-free survival (GRFS) 39.4% (95%CI: 27.8–50.7), and overall survival (OS) 60.8% (95%CI: 47.9–71.4), and did not differ between ST and HD patients. In a matched-pair analysis, there was no difference in RI, GRFS, NRM, LFS, or OS between s-ALL and dn-ALL except for a higher incidence of chronic GvHD (51.9% vs. 31.4%) in s-ALL. To conclude, patients with s-ALL who received HCT in CR1 have comparable outcomes to patients with dn-ALL.

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Fig. 1
Fig. 2: Comparison of HCT outcomes in patients with dn-ALL and s-ALL.

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Data availability

ASK, JMZ, ML, and MM had full access to all study data (available upon data-specific request).

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Authors and Affiliations

  1. Department of Hematology and Transplantology, Medical University of Gdańsk, Gdańsk, Poland

    A. Sadowska-Klasa & J. M. Zaucha

  2. Department of Hematology, Sorbonne University, Hopital Saint Antoine, Paris, France

    M. Labopin & M. Mohty

  3. Department of Hematology, Gustave Roussy Cancer Campus, BMT Service, Villejuif, France

    J. H. Bourhis

  4. Programme de Transplantation & Therapie Cellulaire, Centre de Recherche en Cancérologie de Marseille, Institut Paoli Calmettes, Marseille, France

    D. Blaise

  5. CHU de Lille, LIRIC, INSERM U995, Université de Lille, Lille, France

    I. Yakoub-Agha

  6. HUCH Comprehensive Cancer Center, Stem Cell Transplantation Unit, Helsinki, Finland

    U. Salmenniemi

  7. University Hospital, Hematology, Basel, Switzerland

    J. Passweg

  8. CHU Lapeyronie, Département d’Hématologie Clinique, Montpellier, France

    N. Fegueux

  9. Department of Bone Marrow Transplantation, University Hospital, Essen, Germany

    T. Schroeder

  10. Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland

    S. Giebel

  11. Service d’Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Sorbonne University, and INSERM UMRs 938, Paris, France

    E. Brissot

  12. Ospedale San Raffaele, Haematology and BMT, Milan, Italy

    F. Ciceri

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  1. A. Sadowska-Klasa
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  2. J. M. Zaucha
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Contributions

ASK wrote the manuscript, designed the study, and interpreted the data. JMZ and MM designed the study, interpreted the data, and edited the manuscript. ML designed the study, performed the statistical analyses, interpreted the data, and edited the manuscript. JHB, DB, IYA, US, JP, NF, TS, SG, EB, and FC reviewed the manuscript and provided clinical data. All authors approved the final version of the manuscript.

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Correspondence to A. Sadowska-Klasa or J. M. Zaucha.

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Sadowska-Klasa, A., Zaucha, J.M., Labopin, M. et al. Allogeneic hematopoietic cell transplantation is equally effective in secondary acute lymphoblastic leukemia (ALL) compared to de-novo ALL—a report from the EBMT registry. Bone Marrow Transplant 59, 387–394 (2024). https://doi.org/10.1038/s41409-023-02192-0

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