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Graft vs host disease impacts overall survival post allogeneic hematopoietic stem cell transplantation for acute lymphoblastic leukemia/lymphoma

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World Journal of Transplantation 2018年第7期8卷 252-261页

作者： moussab damlaj Mohammad Snnallah Ayman Alhejazi Samer Ghazi Bader Alahmari Ahmed Alaskar Mohsen Al-Zahrani Division of Hematology and HCT Department of Oncology King Abdulaziz Medical City King Abdullah International Medical Research Center King Saud bin Abdulaziz University for Health Sciences

AIM To examine the outcome and prognostic factors for high risk patients with acute lymphoblastic leukemia/lymphoma(ALL/LBL) who underwent allogeneic hematopoietic stem cell transplantation(HCT) at our center during the period of2010-2017 METHODS After due institutional review board approval, patients with high risk ALL/LBL post HCT were identified and included. All records were retrospectively collected. Time to event analysis was calculated from the date of HCT until event of interest or last follow up with Kaplan-Meir means. Cox regression model was used for multivariable analysis *** A total of 69 patients were enrolled and examined with a median age of 21(14-61). After a median follow up of 15 mo(2-87.3), the 2-year cumulative incidence of relapse, cumulative incidence of non-relapse mortality, progression free survival and overall survival(OS) were 34.1%, 10.9%, 54.9% and 62.8%,respectively. In a multivariable analysis for OS; acute graft vs host disease(GVHD) and chronic GVHD were significant with corresponding hazard ratio 4.9(1.99-12; P = 0.0007) and 0.29(0.1-0.67; P = 0.0044), *** Allogeneic-HCT for high risk ALL/LBL resulted in promising remissions particularly for patients with cGVHD.

关键词： Acute lymphoblastic leukemia Allogeneic hematopoietic stem cell transplant Lymphoblastic lymphoma Complete remission

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Lymphocyte recovery is an independent predictor of relapse in allogeneic hematopoietic cell transplantation recipients for acute leukemia

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World Journal of Transplantation 2017年第4期7卷 235-242页

作者： moussab damlaj Samer Ghazi Walid Mashaqbeh Gamal Gmati Hend Salama Khadega A Abuelgasim Mushtaq Rather Ali Hajeer Mohsen Al-Zahrani Abdul-Rahman Jazieh Ayman Hejazi Ahmad Al Askar Division of Hematology and HSCT Department of Oncology King Abdulaziz Medical City King Abdullah International Medical Research Center King Saud bin Abdulaziz University for Health Sciences

AIM To examine the optimal absolute lymphocyte count(ALC) cut-off utilizing receiver operator characteristics(ROC) in addition to graft characteristics associated with early ALC *** Patients who received T-cell replete peripheral hematopoietic cell transplantation(HCT) for acute leukemia were identified. ALC cut-off was established using ROC analysis and subsequently the cohort was stratified. Time to endpoint analysis and cox regression modelling was computed to analyze outcomes. RESULTS A total of 72 patients met the inclusion criteria andwere analyzed. Optimal ALC cut-off was established to be on day 14(D14) with ALC > 0.3 × 10~9/L. At 2 years, cumulative incidence of relapse was 16.9% vs 46.9%(P = 0.025) for early and delayed lymphocyte recovery cohorts, respectively. Chronic graft vs host disease was more prevalent in the early lymphocyte recovery(ELR) group at 70% vs 27%, respectively(P = 0.0006). On multivariable analysis for relapse, ELR retained its prognostic significance with HR = 0.27(0.05-0.94, P = 0.038).CONCLUSION ELR is an independent predictor for relapse in patients receiving allogeneic HCT for acute leukemia. ELR was influenced by graft characteristics particularly CD34 count.

关键词： Acute leukemia Allogeneic transplant Absolute lymphocyte count

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