The impact of the number of induction cycles required to achieve first complete remission (CR1) on transplant outcomes in adult acute lymphoblastic leukemia (ALL) patients remains unknown. We conducted a retrospective EBMT registry analysis (2000–2022) of ALL patients who underwent transplantation in CR1 after one (n = 2038), two (n = 296), or three or more (n = 110) induction cycles. Median age was 40 years (range 18–73); 79% had B-ALL. At 2 years, relapse incidence was 23%, 31%, and 32%, while non-relapse mortality was 17%, 18%, and 16%, for those achieving CR1 after one, two, and ≥3 cycles, respectively. Multivariable analysis showed that requiring ≥2 cycles was associated with increased relapse risk. Leukemia‐free survival (LFS) at 2 years was 60%, 51%, and 52%, and overall survival (OS) was 68%, 61%, and 60%, for patients needing one, two, and ≥3 cycles, respectively. Multivariable analysis confirmed significantly worse LFS and OS in patients requiring multiple cycles versus one. These findings suggest that the number of induction cycles to achieve CR1 is a key prognostic factor for post-transplant outcomes in adult ALL and support the development of risk-adapted strategies in this setting.
Impact of pre-transplant induction cycles on post-transplant outcomes in patients with ALL: a study from the ALWP EBMT / Montoro, J., Ferhat, A.-T., Dhedin, N., Yakoub-Agha, I., Versluis, J., Blaise, D., Balsat, M., Forcade, E., Castilla-Llorente, C., Chevallier, P., Roeven, M., Sanz, J., Mejia, L., Salmenniemi, U., Errico, G., Snowden, J.A., Passweg, J., Wu, D., Maertens, J., Huynh, A., et al.. - In: BONE MARROW TRANSPLANTATION. - ISSN 0268-3369. - 60:10(2025), pp. 1309-1315. [10.1038/s41409-025-02669-0]
Impact of pre-transplant induction cycles on post-transplant outcomes in patients with ALL: a study from the ALWP EBMT
Ciceri F.
2025-01-01
Abstract
The impact of the number of induction cycles required to achieve first complete remission (CR1) on transplant outcomes in adult acute lymphoblastic leukemia (ALL) patients remains unknown. We conducted a retrospective EBMT registry analysis (2000–2022) of ALL patients who underwent transplantation in CR1 after one (n = 2038), two (n = 296), or three or more (n = 110) induction cycles. Median age was 40 years (range 18–73); 79% had B-ALL. At 2 years, relapse incidence was 23%, 31%, and 32%, while non-relapse mortality was 17%, 18%, and 16%, for those achieving CR1 after one, two, and ≥3 cycles, respectively. Multivariable analysis showed that requiring ≥2 cycles was associated with increased relapse risk. Leukemia‐free survival (LFS) at 2 years was 60%, 51%, and 52%, and overall survival (OS) was 68%, 61%, and 60%, for patients needing one, two, and ≥3 cycles, respectively. Multivariable analysis confirmed significantly worse LFS and OS in patients requiring multiple cycles versus one. These findings suggest that the number of induction cycles to achieve CR1 is a key prognostic factor for post-transplant outcomes in adult ALL and support the development of risk-adapted strategies in this setting.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
