Experience of the Spanish Group for Hematopoietic Transplantation (GETMON-GETH) in allogenic hematopoietic stem cell transplantation in Philadelphia acute lymphoblastic leukemia

• Published in: Anales de Pediatría
• Main Authors: Galán Gómez, Víctor, de la Fuente Regaño, Lydia, Rodríguez Villa, Antonia, Díaz de Heredia Rubio, Cristina, González Vicent, Marta, Badell Serra, Isabel, Fernández, José María, Pascual Martínez, Antonia Isabel, Pérez Hurtado, José María, López Duarte, Mónica, Maldonado Regalado, M Soledad, Pérez-Martínez, Antonio
• Format: Journal Article
• Language: English; Spanish
• Published: Spain 01-04-2022
• Subjects: Cromosoma de Philadelphia; Graft versus host disease; Imatinib; Leucemia linfoblástica aguda; Acute lymphoblastic leukemia; BCR/ABL; Trasplante de progenitores hematopoyéticos; Enfermedad de injerto contra receptor; Hematopoietic stem cell transplantation; Philadelphia chromosome
• ISSN: 2341-2879
• DOI: 10.1016/j.anpedi.2021.02.015

Outcomes in patients diagnosed of acute lymphoblastic leukemia with Philadelphia chromosome (Ph-ALL) remains unfavourable compared to other subtypes of acute lymphoblastic leukemia despite improvements in drug treatments as well as advances in hematopoietic stem cell transplantation (HSCT).
The role of allogeneic HSCT in Ph-ALL patients has been analysed through a multicentric study where data belonging to 70 patients diagnosed of this entity in different center that received HSCT between years 1998 and 2014, were reported by the Grupo Español de Trasplante Hematopoyético (GETH).
The performance of HSCT from year 2004, in first complete remission (CR) status with thymoglobulin (ATG) based conditioning had a favorable impact on overall survival (OS). HSTC performance from year 2004, in first CR with ATG-based conditioning in addition to acute graft versus host disease (aGvHD) development, increased event free survival (EFS). Treatment with imatinib as well as undetectable minimal residual disease (MRD) prior to HSCT, combined with aGvHD, reduced risk of relapse (RR). Patient age less than 10 years when HSCT, first CR and ATG-based conditioning were associated to a lower transplant related mortality (TRM).
Patients that could achieve first CR that also received ATG-based conditioning had a better OS and EFS, so HSCT should be considered for this group of patients.