The impact of the graft-versus-leukemia effect on survival in acute lymphoblastic leukemia

Blood Advances
Moshe YeshurunVeronika Bachanova

Abstract

Allogeneic hematopoietic cell transplant is a potential curative therapy for acute lymphoblastic leukemia (ALL). Delineating the graft-versus-leukemia (GVL) effect as a function of graft-versus-host disease (GVHD) offers the potential to improve survival. We examined 5215 transplant recipients with ALL reported to the Center for International Blood and Marrow Transplant Research registry. Overall survival (OS) was compared according to the presence and severity of GVHD and evaluated in 3 cohorts: 2593 adults in first or second complete remission (CR1/CR2), 1619 pediatric patients in CR1/CR2, and 1003 patients with advanced (CR ≥3 or active disease) ALL. For patients in CR1/CR2, development of acute GVHD (aGVHD) or chronic GVHD (cGVHD) was associated with lower risk of relapse than no GVHD (hazard ratio [HR], 0.49-0.69). Patients with advanced ALL developing grades III and IV aGVHD or cGVHD were also at lower risk of relapse (HRs varied from 0.52 to 0.67). Importantly, adult and children in CR1/CR2 with grades I and II aGVHD without cGVHD experienced the best OS compared with no GVHD (reduction of mortality with HR, 0.83-0.76). Increased nonrelapse mortality accompanied grades III and IV aGVHD (HRs varied from 2.69 to 3.91) in a...Continue Reading

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Citations

Mar 3, 2020·British Journal of Haematology·Yu AkahoshiUNKNOWN Adult Acute Lymphoblastic Leukemia Working Group of the Japan Society for Hematopoietic Cell Transplantation
Mar 18, 2020·British Journal of Haematology·Frédéric Baron, Bipin N Savani
Jan 16, 2020·Immunity·Jérôme Galon, Daniela Bruni
Sep 23, 2020·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Cheng HouDaihong Liu
Jan 4, 2020·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Kentaro IdoHirohisa Nakamae
Mar 27, 2021·Stem Cell Research & Therapy·Margaret G LambDean A Lee
May 19, 2021·Transplantation and Cellular Therapy·Haesook T KimDaniel J Weisdorf
Jun 24, 2021·Clinical Cancer Research : an Official Journal of the American Association for Cancer Research·Takaaki KonumaFumihiko Kimura
Sep 10, 2021·Journal of Cancer Research and Clinical Oncology·Simona Jurkovic MlakarUNKNOWN paediatric diseases working party of the European society for blood and marrow transplantation

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