Survival Increase Seen for Adults With Relapsed Ph+ ALL

Real-world data show steady improvement in overall survival (OS) for patients with Philadelphia-positive (Ph+) acute lymphoblastic leukemia (ALL) who experienced relapse after allogeneic hematopoietic cell transplantation (allo-HCT), according to a study published online Jan. 12 in Clinical Cancer Research.

Ali Bazarbachi, M.D., Ph.D., from the American University of Beirut Medical Center in Lebanon, and colleagues compared outcomes at European Society for Blood and Marrow Transplantation-participating centers for 899 adult patients with Ph+ ALL who relapsed after allo-HCT performed in first complete remission. Trends in outcomes were examined between 2000 and 2019.

Overall, 116, 225, 294, and 264 patients relapsed between 2000 and 2004, 2005 and 2009, 2010 and 2014, and 2015 and 2019, respectively. The researchers found that patient and transplant characteristics were mainly similar over the four time periods. There was an increase in two-year OS from 27.8 to 54.8 percent for patients relapsing between 2000 and 2004 and 2015 and 2019, respectively. Overall, 13.9 percent of the patients underwent a second allo-HCT within two years after relapse, resulting in a two-year OS of 35.9 percent. In a multivariable analysis, factors positively associated with OS from relapse included longer time from transplant to relapse and year of relapse.

"We observed a major progressive improvement in OS from posttransplant relapse for patients with Ph+ ALL, likely reflecting the efficacy of posttransplant salvage strategies," the authors write. "These large-scale real-world data can serve as a benchmark for future studies in this setting."