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ASCT improved outcomes in Ph+ALL
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Autologous stem cell transplantation significantly improved outcomes in patients with Philadelphia-positive acute lymphoblastic leukemia, according to study results.
Outcomes in patients with Ph+ALL improved considerably after the introduction of tyrosine kinase inhibitors. Researchers conducted the current study to determine if ASCT — which has never been considered a standard of care in Ph+ALL — improved outcomes in the TKI era.
Researchers analyzed 177 patients with Ph+ ALL in first complete remission to determine the effects year of transplantation had on outcomes.
Results showed 3-year OS rates were 16% among patients who underwent transplant between 1996 and 2001, 48% for those who underwent transplant between 2002 and 2006, and 57% for those who underwent transplant between 2007 and 2010 (P<.0001). Leukemia-free survival rates increased from 11% for the 1996-2001 group to 39% for the 2002-2006 group and 52% for the 2007-2010 group (P<.0001).
When the researchers analyzed a subgroup of 22 patients treated with TKI and in complete molecular remission at the time of transplant, they observed a leukemia-free survival rate of 65% at 3 years.
The incidence for relapse decreased from 70% for transplants performed in 1996-2001 to 45% for transplants performed in 2002-2006 and 2007-2010 (P=.01). Nonrelapse mortality decreased from 19% for transplants performed from 1996-2001 to 15% for those performed from 2002-2006 and 3% for those performed from 2007-2010 (P=.08).
The year that a transplant was performed was the one independent factor associated with treatment failure (HR=0.37; P<.001).
“Prospective, innovative studies are needed to verify the role of autologous stem cell transplantation in this patient setting,” the researchers wrote.
Disclosure: See the study for a full list of the researchers’ relevant disclosures.
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