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Allogeneic hematopoietic cell transplantation for older patients with Philadelphia-positive acute lymphoblastic leukemia: a study by the Acute Leukemia Working Party of the EBMT

The role of allogeneic hematopoietic cell transplantation (allo-HCT) in older patients with Philadelphia-positive acute lymphoblastic leukemia (Ph+ ALL) is not well established. In this retrospective analysis we evaluated outcomes of 566 patients with median age of 60 (range 55-76) years treated in...

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Main Authors: Giebel, Sebastian (Author) , Labopin, Myriam (Author) , Swoboda, Ryszard (Author) , Blaise, Didier (Author) , Yakoub-Agha, Ibrahim (Author) , Nguyen, Stephanie (Author) , Wagner-Drouet, Eva Maria (Author) , Castilla-Llorente, Cristina (Author) , Kottaridis, Panagiotis (Author) , Schroeder, Thomas (Author) , Fanin, Renato (Author) , Passweg, Jakob (Author) , Versluis, Jurjen (Author) , Crawley, Charles (Author) , Gabellier, Ludovic (Author) , Mielke, Stephan (Author) , Poiré, Xavier (Author) , Nur, Erfan (Author) , Vaz, Carlos Pinho (Author) , Eder, Matthias (Author) , Nozzoli, Chiara (Author) , Dreger, Peter (Author) , Peric, Zinaida (Author) , Mohty, Mohamad (Author) , Ciceri, Fabio (Author)
Format: Article (Journal)
Language:English
Published: 16 July 2025
In: Bone marrow transplantation
Year: 2025, Volume: 60, Issue: 10, Pages: 1325-1332
ISSN:1476-5365
DOI:10.1038/s41409-025-02667-2
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1038/s41409-025-02667-2
Verlag, lizenzpflichtig, Volltext: https://www.nature.com/articles/s41409-025-02667-2
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Author Notes:Sebastian Giebel, Myriam Labopin, Ryszard Swoboda, Didier Blaise, Ibrahim Yakoub-Agha, Stephanie Nguyen, Eva Maria Wagner-Drouet, Cristina Castilla-Llorente, Panagiotis Kottaridis, Thomas Schroeder, Renato Fanin, Jakob Passweg, Jurjen Versluis, Charles Crawley, Ludovic Gabellier, Stephan Mielke, Xavier Poiré, Erfan Nur, Carlos Pinho Vaz, Matthias Eder, Chiara Nozzoli, Peter Dreger, Zinaida Peric, Mohamad Mohty and Fabio Ciceri
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Summary:The role of allogeneic hematopoietic cell transplantation (allo-HCT) in older patients with Philadelphia-positive acute lymphoblastic leukemia (Ph+ ALL) is not well established. In this retrospective analysis we evaluated outcomes of 566 patients with median age of 60 (range 55-76) years treated in first complete remission with allo-HCT from either a matched sibling (n = 138), unrelated (n = 343) or haploidentical (n = 85) donor between the years 2016 and 2022. The probability of overall survival (OS) and leukemia-free survival (LFS) at 2 years was 71% and 59.5%, respectively. The incidence of relapse, and non-relapse mortality (NRM) was 18% and 22.5%, respectively. The rate of graft-versus-host disease (GVHD)-free, relapse-free survival was 50%. In a multivariate model, the use of total body irradiation (TBI) was the only factor affecting outcomes, being associated with reduced risk of NRM (hazard ratio, [HR] = 0.46, p = 0.004), improved LFS (HR = 0.53, p < 0.001) and OS (HR = 0.47, p < 0.001) as well as increased risk of chronic GVHD (HR = 1.68, p = 0.009) and extensive chronic GVHD (HR = 1.84, p = 0.04). We conclude that in the last few years, outcomes of allo-HCT for patients with Ph+ ALL aged ≥55 years are encouraging. TBI-based reduced intensity conditioning appears preferable in this patient population. Our data can serve as a reference for future prospective trials.
Item Description:Veröffentlicht: 16. Juli 2025
Gesehen am 27.11.2025
Physical Description:Online Resource
ISSN:1476-5365
DOI:10.1038/s41409-025-02667-2

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