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Indications for Allogeneic HCT in Adults with Acute Lymphoblastic Leukemia in First Complete Remission

  • Leukemia (PH Wiernik, Section Editor)
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Opinion statement

Acute lymphoblastic leukemia (ALL) in adults is associated with poor outcomes as compared to children when treated with chemotherapy, leading to a considerably inferior cure rate. Historically, consolidation with allogeneic hematopoietic cell transplant (alloHCT) was routinely recommended for eligible adults with ALL in first complete remission (CR1) if a donor was available, since randomized studies showed superiority over continuing chemotherapy. With the increasing use of pediatric-inspired frontline regimens in young adults with ALL and the availability of novel salvage agents for relapsed/refractory B-cell ALL that have high potential in inducing a second CR, the role of early alloHCT in the treatment paradigm for ALL needs to be reevaluated, and the decision should be individualized for each patient. Simultaneously, alloHCT has evolved considerably lately, and historical randomized studies that have proven the benefit of alloHCT in adults with ALL in CR1 did not included the increasing use of reduced intensity conditioning and haploidentical transplants, and therefore, data may not entirely apply. Nowadays, detectable minimal residual disease (MRD) is the most prognostic determinant of ALL outcome and should be a major consideration in the decision to perform alloHcT in CR1. Nonetheless, other biological and clinical factors remain relevant and can support the complex decision-making. Such factors include high-risk leukemia genetics, the type of administered chemotherapy regimen and the ability of the patient to tolerate all key components of the regimen, and the availability of effective salvage therapies that allow alloHCT to be performed in CR2 in case of relapse after chemotherapy.

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References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Danese MD, Katz A, Cetin K, Chia V, Gleeson ML, Kelsh M, et al. Treatment patterns, survival, and hospitalization in adult patients with acute lymphoblastic leukemia: an observational cohort study using SEER Medicare data. Leuk Lymphoma. 2019;60(8):2015–24.

    Article  PubMed  Google Scholar 

  2. Hunger SP, Lu X, Devidas M, Camitta BM, Gaynon PS, Winick NJ, et al. Improved survival for children and adolescents with acute lymphoblastic leukemia between 1990 and 2005: a report from the children's oncology group. J Clin Oncol : official journal of the American Society of Clinical Oncology. 2012;30(14):1663–9.

    Article  Google Scholar 

  3. Aldoss I, Stein AS. Advances in adult acute lymphoblastic leukemia therapy. Leuk Lymphoma. 2018;59(5):1033–50.

    Article  PubMed  Google Scholar 

  4. O'Brien S, Thomas DA, Ravandi F, Faderl S, Pierce S, Kantarjian H. Results of the hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone regimen in elderly patients with acute lymphocytic leukemia. Cancer. 2008;113(8):2097–101.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Sive JI, Buck G, Fielding A, Lazarus HM, Litzow MR, Luger S, et al. Outcomes in older adults with acute lymphoblastic leukaemia (ALL): results from the international MRC UKALL XII/ECOG2993 trial. Br J Haematol. 2012;157(4):463–71.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Larson RA, Dodge RK, Linker CA, Stone RM, Powell BL, Lee EJ, et al. A randomized controlled trial of filgrastim during remission induction and consolidation chemotherapy for adults with acute lymphoblastic leukemia: CALGB study 9111. Blood. 1998;92(5):1556–64.

    CAS  PubMed  Google Scholar 

  7. Stein A, Forman SJ. Allogeneic transplantation for ALL in adults. Bone Marrow Transplant. 2008;41(5):439–46.

    Article  CAS  PubMed  Google Scholar 

  8. Moorman AV, Harrison CJ, Buck GA, Richards SM, Secker-Walker LM, Martineau M, et al. Karyotype is an independent prognostic factor in adult acute lymphoblastic leukemia (ALL): analysis of cytogenetic data from patients treated on the Medical Research Council (MRC) UKALLXII/Eastern Cooperative Oncology Group (ECOG) 2993 trial. Blood. 2007;109(8):3189–97.

    Article  CAS  PubMed  Google Scholar 

  9. Wetzler M, Dodge RK, Mrozek K, Carroll AJ, Tantravahi R, Block AW, et al. Prospective karyotype analysis in adult acute lymphoblastic leukemia: the cancer and leukemia Group B experience. Blood. 1999;93(11):3983–93.

    CAS  PubMed  Google Scholar 

  10. Maury S, Huguet F, Leguay T, Lacombe F, Maynadie M, Girard S, et al. Adverse prognostic significance of CD20 expression in adults with Philadelphia chromosome-negative B-cell precursor acute lymphoblastic leukemia. Haematologica. 2010;95(2):324–8.

    Article  PubMed  Google Scholar 

  11. Thomas DA, O'Brien S, Jorgensen JL, Cortes J, Faderl S, Garcia-Manero G, et al. Prognostic significance of CD20 expression in adults with de novo precursor B-lineage acute lymphoblastic leukemia. Blood. 2009;113(25):6330–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Hoelzer D, Thiel E, Loffler H, Buchner T, Ganser A, Heil G, et al. Prognostic factors in a multicenter study for treatment of acute lymphoblastic leukemia in adults. Blood. 1988;71(1):123–31.

    Article  CAS  PubMed  Google Scholar 

  13. Kantarjian HM, O'Brien S, Smith TL, Cortes J, Giles FJ, Beran M, et al. Results of treatment with hyper-CVAD, a dose-intensive regimen, in adult acute lymphocytic leukemia. J Clin Oncol. 2000;18(3):547–61.

    Article  CAS  PubMed  Google Scholar 

  14. Mortuza FY, Papaioannou M, Moreira IM, Coyle LA, Gameiro P, Gandini D, et al. Minimal residual disease tests provide an independent predictor of clinical outcome in adult acute lymphoblastic leukemia. J Clin Oncol. 2002;20(4):1094–104.

    Article  PubMed  Google Scholar 

  15. Gokbuget N, Kneba M, Raff T, Trautmann H, Bartram CR, Arnold R, et al. Adult patients with acute lymphoblastic leukemia and molecular failure display a poor prognosis and are candidates for stem cell transplantation and targeted therapies. Blood. 2012;120(9):1868–76.

    Article  PubMed  Google Scholar 

  16. Bruggemann M, Gokbuget N, Kneba M. Acute lymphoblastic leukemia: monitoring minimal residual disease as a therapeutic principle. Semin Oncol. 2012;39(1):47–57.

    Article  PubMed  Google Scholar 

  17. Bruggemann M, Kotrova M. Minimal residual disease in adult ALL: technical aspects and implications for correct clinical interpretation. Blood Adv. 2017;1(25):2456–66.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Bruggemann M, Raff T, Flohr T, Gokbuget N, Nakao M, Droese J, et al. Clinical significance of minimal residual disease quantification in adult patients with standard-risk acute lymphoblastic leukemia. Blood. 2006;107(3):1116–23.

    Article  PubMed  Google Scholar 

  19. Pui CH, Relling MV, Downing JR. Acute lymphoblastic leukemia. N Engl J Med. 2004;350(15):1535–48.

    Article  CAS  PubMed  Google Scholar 

  20. Faderl S, Kantarjian HM, Talpaz M, Estrov Z. Clinical significance of cytogenetic abnormalities in adult acute lymphoblastic leukemia. Blood. 1998;91(11):3995–4019.

    Article  CAS  PubMed  Google Scholar 

  21. Graux C, Cools J, Michaux L, Vandenberghe P, Hagemeijer A. Cytogenetics and molecular genetics of T-cell acute lymphoblastic leukemia: from thymocyte to lymphoblast. Leukemia. 2006;20(9):1496–510.

    Article  CAS  PubMed  Google Scholar 

  22. Mittelman F. The third international workshop on chromosomes in leukemia. Lund, Sweden, July 21-25, 1980. Introduction. Cancer Genet Cytogenet. 1981;4(2):96–8.

    CAS  PubMed  Google Scholar 

  23. Goldstone AH, Richards SM, Lazarus HM, Tallman MS, Buck G, Fielding AK, et al. In adults with standard-risk acute lymphoblastic leukemia, the greatest benefit is achieved from a matched sibling allogeneic transplantation in first complete remission, and an autologous transplantation is less effective than conventional consolidation/maintenance chemotherapy in all patients: final results of the International ALL Trial (MRC UKALL XII/ECOG E2993). Blood. 2008;111(4):1827–33.

    Article  CAS  PubMed  Google Scholar 

  24. Cornelissen JJ, van der Holt B, Verhoef GE, van't Veer MB, van Oers MH, Schouten HC, et al. Myeloablative allogeneic versus autologous stem cell transplantation in adult patients with acute lymphoblastic leukemia in first remission: a prospective sibling donor versus no-donor comparison. Blood. 2009;113(6):1375–82.

    Article  CAS  PubMed  Google Scholar 

  25. Jamieson CH, Amylon MD, Wong RM, Blume KG. Allogeneic hematopoietic cell transplantation for patients with high-risk acute lymphoblastic leukemia in first or second complete remission using fractionated total-body irradiation and high-dose etoposide: a 15-year experience. Exp Hematol. 2003;31(10):981–6.

    Article  PubMed  Google Scholar 

  26. Ribera JM, Oriol A, Bethencourt C, Parody R, Hernandez-Rivas JM, Moreno MJ, et al. Comparison of intensive chemotherapy, allogeneic or autologous stem cell transplantation as post-remission treatment for adult patients with high-risk acute lymphoblastic leukemia. Results of the PETHEMA ALL-93 trial. Haematologica. 2005;90(10):1346–56.

    CAS  PubMed  Google Scholar 

  27. •• Giebel S, Boumendil A, Labopin M, Seesaghur A, Baron F, Ciceri F, et al. Trends in the use of hematopoietic stem cell transplantation for adults with acute lymphoblastic leukemia in Europe: a report from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation (EBMT). Ann Hematol. 2019;98(10):2389–98 important retrospective review of outcoimes of a large number of patients with ALL who underwent HCT reported to EBMT.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Giebel S, Labopin M, Socie G, Beelen D, Browne P, Volin L, et al. Improving results of allogeneic hematopoietic cell transplantation for adults with acute lymphoblastic leukemia in first complete remission: an analysis from the acute leukemia working party of the European Society for Blood and Marrow Transplantation. Haematologica. 2017;102(1):139–49.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Srour SA, Milton DR, Bashey A, Karduss-Urueta A, Al Malki MM, Romee R, et al. Haploidentical transplantation with post-transplantation cyclophosphamide for high-risk acute lymphoblastic leukemia. Biol Blood Marrow Transplant. 2017;23(2):318–24.

    Article  CAS  PubMed  Google Scholar 

  30. • Santoro N, Ruggeri A, Labopin M, Bacigalupo A, Ciceri F, Gulbas Z, et al. Unmanipulated haploidentical stem cell transplantation in adults with acute lymphoblastic leukemia: a study on behalf of the acute leukemia working party of the EBMT. J Hematol Oncol. 2017;10(1):113 a large registry (EBMT) study reported outcomes of haplo-HCT in patients with ALL and concluded that haploHCT be considered for patients with ALL who do not have MSD or MUD available for transplant.

    Article  PubMed  PubMed Central  Google Scholar 

  31. • Al Malki MM, Yang D, Labopin M, Afanasyev B, Angelucci E, Bashey A, et al. Comparing transplant outcomes in ALL patients after haploidentical with PTCy or matched unrelated donor transplantation. Blood Adv. 2020;4(9):2073–83 Importance: a large multi-center retrospective study showed that outcomes of haploidentical donor transplant are comparable to matched unrelated donor HCT in patients with ALL. This is important as many patients would not have a MSD and MUD, and will have at least one feasible haploidenticle donor for this curative therapy.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Terakura S, Atsuta Y, Tsukada N, Kobayashi T, Tanaka M, Kanda J, et al. Comparison of outcomes of 8/8 and 7/8 allele-matched unrelated bone marrow transplantation and single-unit cord blood transplantation in adults with acute leukemia. Biol Blood Marrow Transplant. 2016;22(2):330–8.

    Article  PubMed  Google Scholar 

  33. Fuchs EJ, O'Donnell PV, Eapen M, Logan B, Antin JH, Dawson P, et al. Double unrelated umbilical cord blood vs HLA-haploidentical bone marrow transplantation: the BMT CTN 1101 trial. Blood. 2021;137(3):420–8.

    Article  CAS  PubMed  Google Scholar 

  34. Douer D, Aldoss I, Lunning MA, Burke PW, Ramezani L, Mark L, et al. Pharmacokinetics-based integration of multiple doses of intravenous pegaspargase in a pediatric regimen for adults with newly diagnosed acute lymphoblastic leukemia. J Clin Oncol : official journal of the American Society of Clinical Oncology. 2014;32(9):905–11.

    Article  CAS  Google Scholar 

  35. DeAngelo DJ, Stevenson KE, Dahlberg SE, Silverman LB, Couban S, Supko JG, et al. Long-term outcome of a pediatric-inspired regimen used for adults aged 18-50 years with newly diagnosed acute lymphoblastic leukemia. Leukemia. 2015;29(3):526–34.

    Article  CAS  PubMed  Google Scholar 

  36. Ribera JM, Oriol A, Sanz MA, Tormo M, Fernandez-Abellan P, del Potro E, et al. Comparison of the results of the treatment of adolescents and young adults with standard-risk acute lymphoblastic leukemia with the Programa Espanol de Tratamiento en Hematologia pediatric-based protocol ALL-96. J Clin Oncol : official journal of the American Society of Clinical Oncology. 2008;26(11):1843–9.

    Article  CAS  Google Scholar 

  37. Huguet F, Leguay T, Raffoux E, Thomas X, Beldjord K, Delabesse E, et al. Pediatric-inspired therapy in adults with Philadelphia chromosome-negative acute lymphoblastic leukemia: the GRAALL-2003 study. J Clin Oncol : official journal of the American Society of Clinical Oncology. 2009;27(6):911–8.

    Article  CAS  Google Scholar 

  38. Rijneveld AW, van der Holt B, Daenen SM, Biemond BJ, de Weerdt O, Muus P, et al. Intensified chemotherapy inspired by a pediatric regimen combined with allogeneic transplantation in adult patients with acute lymphoblastic leukemia up to the age of 40. Leukemia. 2011;25(11):1697–703.

    Article  CAS  PubMed  Google Scholar 

  39. Rytting ME, Thomas DA, O'Brien SM, Ravandi-Kashani F, Jabbour EJ, Franklin AR, et al. Augmented Berlin-Frankfurt-Munster therapy in adolescents and young adults (AYAs) with acute lymphoblastic leukemia (ALL). Cancer. 2014;120(23):3660–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Seftel MD, Neuberg D, Zhang MJ, Wang HL, Ballen KK, Bergeron J, et al. Pediatric-inspired therapy compared to allografting for Philadelphia chromosome-negative adult ALL in first complete remission. Am J Hematol. 2016;91(3):322–9.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Aladag E, Aktimur SH, Aydin O, Demiroglu H, Buyukasik Y, Aksu S, et al. Allogeneic hematopoietic stem-cell transplantation improves disease-free survival compared to pediatric-inspired Berlin-Frankfurt-Munster chemotherapy in adult acute lymphoblastic leukemia. Clin Lymphoma Myeloma Leuk. 2021.

  42. •• De Filipp Z, Advani AS, Bachanova V, Cassaday RD, Deangelo DJ, Kebriaei P, et al. Hematopoietic cell transplantation in the treatment of adult acute lymphoblastic leukemia: updated 2019 evidence-based review from the American society for transplantation and cellular therapy. Biol Blood Marrow Transplant. 2019;25(11):2113–23 important evidence-based review of the indications of HCT in patients with ALL by ASBMT.

    Article  Google Scholar 

  43. •• Giebel S, Marks DI, Boissel N, Baron F, Chiaretti S, Ciceri F, et al. Hematopoietic stem cell transplantation for adults with Philadelphia chromosome-negative acute lymphoblastic leukemia in first remission: a position statement of the European working group for adult acute lymphoblastic leukemia (EWALL) and the acute leukemia working party of the European Society for Blood and Marrow Transplantation (EBMT). Bone Marrow Transplant. 2019;54(6):798–809 important evidence-based review of the indications of HCT in patients with ALL and HCT characteristics by EBMT.

    Article  PubMed  Google Scholar 

  44. Szczepanski T. Why and how to quantify minimal residual disease in acute lymphoblastic leukemia? Leukemia. 2007;21(4):622–6.

    Article  CAS  PubMed  Google Scholar 

  45. Scheuring UJ, Pfeifer H, Wassmann B, Bruck P, Gehrke B, Petershofen EK, et al. Serial minimal residual disease (MRD) analysis as a predictor of response duration in Philadelphia-positive acute lymphoblastic leukemia (Ph+ALL) during imatinib treatment. Leukemia. 2003;17(9):1700–6.

    Article  CAS  PubMed  Google Scholar 

  46. Holowiecki J, Krawczyk-Kulis M, Giebel S, Jagoda K, Stella-Holowiecka B, Piatkowska-Jakubas B, et al. Status of minimal residual disease after induction predicts outcome in both standard and high-risk Ph-negative adult acute lymphoblastic leukaemia. The Polish Adult Leukemia Group ALL 4-2002 MRD Study. Br J Haematol. 2008;142(2):227–37.

    Article  PubMed  Google Scholar 

  47. Bassan R, Spinelli O, Oldani E, Intermesoli T, Tosi M, Peruta B, et al. Improved risk classification for risk-specific therapy based on the molecular study of minimal residual disease (MRD) in adult acute lymphoblastic leukemia (ALL). Blood. 2009;113(18):4153–62.

    Article  CAS  PubMed  Google Scholar 

  48. Ribera JM, Oriol A, Morgades M, Montesinos P, Sarra J, Gonzalez-Campos J, et al. Treatment of high-risk Philadelphia chromosome-negative acute lymphoblastic leukemia in adolescents and adults according to early cytologic response and minimal residual disease after consolidation assessed by flow cytometry: final results of the PETHEMA ALL-AR-03 trial. J Clin Oncol : official journal of the American Society of Clinical Oncology. 2014;32(15):1595–604.

    Article  CAS  Google Scholar 

  49. Stock W, Luger SM, Advani AS, Yin J, Harvey RC, Mullighan CG, et al. A pediatric regimen for older adolescents and young adults with acute lymphoblastic leukemia: results of CALGB 10403. Blood. 2019;133(14):1548–59.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  50. Dhedin N, Huynh A, Maury S, Tabrizi R, Beldjord K, Asnafi V, et al. Role of allogeneic stem cell transplantation in adult patients with Ph-negative acute lymphoblastic leukemia. Blood. 2015;125(16):2486–96 quiz 586.

    Article  CAS  PubMed  Google Scholar 

  51. Aldoss I, Tsai NC, Slovak ML, Palmer J, Alvarnas J, Marcucci G, et al. Cytogenetics does not impact outcomes in adult patients with acute lymphoblastic leukemia undergoing allogeneic hematopoietic cell transplantation. Biol Blood Marrow Transplant. 2016;22(7):1212–7.

    Article  PubMed  Google Scholar 

  52. Lazaryan A, Dolan M, Zhang MJ, Wang HL, Kharfan-Dabaja MA, Marks DI, et al. Impact of cytogenetic abnormalities on outcomes of adult Philadelphia-negative acute lymphoblastic leukemia after allogeneic hematopoietic stem cell transplantation: a study by the Acute leukemia working committee of the center for International Blood and Marrow Transplant Research. Haematologica. 2020;105(5):1329–38.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  53. Roberts KG, Gu Z, Payne-Turner D, McCastlain K, Harvey RC, Chen IM, et al. High frequency and poor outcome of Philadelphia chromosome-like acute lymphoblastic leukemia in adults. J Clin Oncol : official journal of the American Society of Clinical Oncology. 2017;35(4):394–401.

    Article  Google Scholar 

  54. Jain N, Roberts KG, Jabbour E, Patel K, Eterovic AK, Chen K, et al. Ph-like acute lymphoblastic leukemia: a high-risk subtype in adults. Blood. 2017;129(5):572–81.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  55. Roberts KG, Li Y, Payne-Turner D, Harvey RC, Yang YL, Pei D, et al. Targetable kinase-activating lesions in Ph-like acute lymphoblastic leukemia. N Engl J Med. 2014;371(11):1005–15.

    Article  PubMed  PubMed Central  Google Scholar 

  56. Den Boer ML, van Slegtenhorst M, De Menezes RX, Cheok MH, Buijs-Gladdines JG, Peters ST, et al. A subtype of childhood acute lymphoblastic leukaemia with poor treatment outcome: a genome-wide classification study. Lancet Oncol. 2009;10(2):125–34.

    Article  Google Scholar 

  57. Chiaretti S, Messina M, Della Starza I, Piciocchi A, Cafforio L, Cavalli M, et al. Philadelphia-like acute lymphoblastic leukemia is associated with minimal residual disease persistence and poor outcome. First report of the minimal residual disease-oriented GIMEMA LAL1913. Haematologica. 2020. this study confirms the poor-risk feature of Ph- ALL with increased risk of MRD persistence with therapy and risk of relapse hence early recognition of this entity with risk stratified treatment strategies such as early HCT may help improve outcomes.

  58. Aldoss I, Advani AS. Have any strategies in Ph-like ALL been shown to be effective? Best Pract Res Clin Haematol. 2021;34:101242.

    Article  CAS  PubMed  Google Scholar 

  59. Snyder DS. Allogeneic stem cell transplantation for Philadelphia chromosome-positive acute lymphoblastic leukemia. Biol Blood Marrow Transplant. 2000;6(6):597–603.

    Article  CAS  PubMed  Google Scholar 

  60. Hoelzer D, Gokbuget N, Ottmann OG. Targeted therapies in the treatment of Philadelphia chromosome-positive acute lymphoblastic leukemia. Semin Hematol. 2002;39(4 Suppl 3):32–7.

    Article  CAS  PubMed  Google Scholar 

  61. Fielding AK, Rowe JM, Buck G, Foroni L, Gerrard G, Litzow MR, et al. UKALLXII/ECOG2993: addition of imatinib to a standard treatment regimen enhances long-term outcomes in Philadelphia positive acute lymphoblastic leukemia. Blood. 2014;123(6):843–50.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  62. Dombret H, Gabert J, Boiron JM, Rigal-Huguet F, Blaise D, Thomas X, et al. Outcome of treatment in adults with Philadelphia chromosome-positive acute lymphoblastic leukemia--results of the prospective multicenter LALA-94 trial. Blood. 2002;100(7):2357–66.

    Article  CAS  PubMed  Google Scholar 

  63. Chalandon Y, Thomas X, Hayette S, Cayuela JM, Abbal C, Huguet F, et al. Randomized study of reduced-intensity chemotherapy combined with imatinib in adults with Ph-positive acute lymphoblastic leukemia. Blood. 2015;125(24):3711–9.

    Article  CAS  PubMed  Google Scholar 

  64. Ravandi F, Othus M, O'Brien SM, Forman SJ, Ha CS, Wong JYC, et al. US Intergroup study of chemotherapy plus dasatinib and allogeneic stem cell transplant in Philadelphia chromosome positive ALL. Blood Adv. 2016;1(3):250–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  65. Bachanova V, Marks DI, Zhang MJ, Wang H, de Lima M, Aljurf MD, et al. Ph+ ALL patients in first complete remission have similar survival after reduced intensity and myeloablative allogeneic transplantation: impact of tyrosine kinase inhibitor and minimal residual disease. Leukemia. 2014;28(3):658–65.

    Article  CAS  PubMed  Google Scholar 

  66. Brissot E, Labopin M, Beckers MM, Socie G, Rambaldi A, Volin L, et al. Tyrosine kinase inhibitors improve long-term outcome of allogeneic hematopoietic stem cell transplantation for adult patients with Philadelphia chromosome positive acute lymphoblastic leukemia. Haematologica. 2015;100(3):392–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  67. Jabbour E, Kantarjian H, Ravandi F, Thomas D, Huang X, Faderl S, et al. Combination of hyper-CVAD with ponatinib as first-line therapy for patients with Philadelphia chromosome-positive acute lymphoblastic leukaemia: a single-centre, phase 2 study. Lancet Oncol. 2015;16(15):1547–55.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  68. Jabbour E, Short NJ, Ravandi F, Huang X, Daver N, DiNardo CD, et al. Combination of hyper-CVAD with ponatinib as first-line therapy for patients with Philadelphia chromosome-positive acute lymphoblastic leukaemia: long-term follow-up of a single-centre, phase 2 study. Lancet Haematol. 2018;5(12):e618–e27.

    Article  PubMed  Google Scholar 

  69. Panosyan EH, Seibel NL, Martin-Aragon S, Gaynon PS, Avramis IA, Sather H, et al. Asparaginase antibody and asparaginase activity in children with higher-risk acute lymphoblastic leukemia: Children's Cancer Group Study CCG-1961. J Pediatr Hematol Oncol. 2004;26(4):217–26.

    Article  PubMed  Google Scholar 

  70. Silverman LB, Gelber RD, Dalton VK, Asselin BL, Barr RD, Clavell LA, et al. Improved outcome for children with acute lymphoblastic leukemia: results of Dana-Farber Consortium Protocol 91-01. Blood. 2001;97(5):1211–8.

    Article  CAS  PubMed  Google Scholar 

  71. Aldoss I, Pullarkat V, Martinez D, Ji L, Douer D. The number of peg-asparaginase doses administered is a determinant of relapse risk in adult ALL treated with a pediatric-like regimen. Blood. 2013;122(21):3915.

    Article  Google Scholar 

  72. Marks DI, Paietta EM, Moorman AV, Richards SM, Buck G, DeWald G, et al. T-cell acute lymphoblastic leukemia in adults: clinical features, immunophenotype, cytogenetics, and outcome from the large randomized prospective trial (UKALL XII/ECOG 2993). Blood. 2009;114(25):5136–45.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  73. Petit A, Trinquand A, Chevret S, Ballerini P, Cayuela JM, Grardel N, et al. Oncogenetic mutations combined with MRD improve outcome prediction in pediatric T-cell acute lymphoblastic leukemia. Blood. 2018;131(3):289–300.

    Article  CAS  PubMed  Google Scholar 

  74. Asnafi V, Buzyn A, Le Noir S, Baleydier F, Simon A, Beldjord K, et al. NOTCH1/FBXW7 mutation identifies a large subgroup with favorable outcome in adult T-cell acute lymphoblastic leukemia (T-ALL): a Group for Research on Adult Acute Lymphoblastic Leukemia (GRAALL) study. Blood. 2009;113(17):3918–24.

    Article  CAS  PubMed  Google Scholar 

  75. Patrick K, Wade R, Goulden N, Mitchell C, Moorman AV, Rowntree C, et al. Outcome for children and young people with Early T-cell precursor acute lymphoblastic leukaemia treated on a contemporary protocol, UKALL 2003. Br J Haematol. 2014;166(3):421–4.

    Article  CAS  PubMed  Google Scholar 

  76. Wood BL, Winter SS, Dunsmore KP, Devidas M, Chen S, Asselin B, et al. T-lymphoblastic leukemia (T-ALL) shows excellent outcome, lack of significance of the early thymic precursor (ETP) immunophenotype, and validation of the prognostic value of end-induction minimal residual disease (MRD) in Children’s Oncology Group (COG) Study AALL0434. Blood. 2014;124(21):1.

    Article  Google Scholar 

  77. Jain N, Lamb AV, O'Brien S, Ravandi F, Konopleva M, Jabbour E, et al. Early T-cell precursor acute lymphoblastic leukemia/lymphoma (ETP-ALL/LBL) in adolescents and adults: a high-risk subtype. Blood. 2016;127(15):1863–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  78. Morita K, Jain N, Kantarjian H, Takahashi K, Fang H, Konopleva M, et al. Outcome of T-cell Acute lymphoblastic leukemia/lymphoma: focus on near-ETP phenotype & differential impact of nelarabine. Am J Hematol. 2021.

  79. Dunsmore KP, Winter SS, Devidas M, Wood BL, Esiashvili N, Chen Z, et al. Children's Oncology Group AALL0434: A phase III randomized clinical trial testing nelarabine in newly diagnosed t-cell acute lymphoblastic leukemia. J Clin Oncol. 2020;38(28):3282–93.

    Article  CAS  PubMed  Google Scholar 

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Arslan, S., Pullarkat, V. & Aldoss, I. Indications for Allogeneic HCT in Adults with Acute Lymphoblastic Leukemia in First Complete Remission. Curr. Treat. Options in Oncol. 22, 63 (2021). https://doi.org/10.1007/s11864-021-00860-1

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