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Outcomes of mixed phenotype acute leukemia undergoing allogeneic stem cell transplantation: a retrospective study of the ALWP of EBMT

Fecha de publicación:

Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • Paviglianiti A.
  • Ngoya M.
  • Peffault de la Tour R.
  • Schroeder T.
  • Remenyi P.
  • Morsink L.
  • Sopko L.
  • Ayuk F.
  • Verbeek M.
  • Durholt M.
  • Kerre T.
  • Eder M.
  • Zak P.
  • Yakoubagha I.
  • Turlure P.
  • Roeven M.W.H.
  • Kulagin A.
  • Maggi A.
  • Ram R.
  • Busca A.
  • Rabitsch W.
  • Schneidawind D.
  • Brissot E.
  • Ciceri F.

Grupos

Abstract

Limited data is available on outcomes of mixed phenotype acute leukemia (MPAL) following allogeneic stem cell transplantation (HCT), and the impact of haploidentical HCT with post-transplant cyclophosphamide in this setting is lacking. We retrospectively analyzed 195 adults with MPAL undergoing HCT in first complete remission from 2014 to 2023. The 2-year overall survival (OS) and leukemia free survival (LFS) were 70.7% and 56.4%. Relapse incidence (RI) was 29.8% and non-relapse mortality was 13.8% at 2 years. The cumulative incidence of grade II-IV and III-IV acute graft versus host disease (GvHD) was 28.8% and 9.3% at 100 days. The 2-year cumulative incidence of chronic GvHD was 36.6%. The 2-year GvHD-free-relapse free survival was 37.6% (95%CI 29.9–45.3%). In multivariate analysis, patients undergoing myeloablative conditioning had better OS (HR 0.5, 95%CI 0.27–0.93, p = 0.03) and LFS (HR 0.49, 95%CI 0.26–0.94, p = 0.03). The use of peripheral blood was associated with better LFS (HR 0.36, 95%CI 0.17–0.76, p = 0.008) and lower RI (HR 0.33, 95%CI 0.12–0.93, p = 0.04). In vivo T-cell depletion was associated with lower incidence of chronic GvHD (HR 0.32, 95%CI 0.17–0.63, p < 0.001). These findings highlight that conditioning intensity, graft source, and T-cell depletion strategies are critical factors in optimizing transplant outcomes for MPAL. © The Author(s), under exclusive licence to Springer Nature Limited 2026.

Datos de la publicación

ISSN/ISSNe:
0268-3369, 1476-5365

BONE MARROW TRANSPLANTATION  SPRINGERNATURE

Tipo:
Article
Páginas:
913-920
PubMed:
42203899
Enlace a otro recurso:
www.scopus.com
Factor de Impacto:
0,998 SCImago ℠
Cuartil:
Q2 SCImago ℠

Citas Recibidas en Web of Science: 1

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Keywords

  • Adolescent; Adult; Female; Graft vs Host Disease; Hematopoietic Stem Cell Transplantation; Humans; Male; Middle Aged; Retrospective Studies; Transplantation Conditioning; Transplantation, Homologous; Treatment Outcome; alemtuzumab; busulfan; cyclophosphamide; cyclosporine; fludarabine; melphalan; methotrexate; mycophenolate mofetil; ponatinib; sirolimus; tacrolimus; thymocyte antibody; treosulfan; acute graft versus host disease; acute leukemia; adult; aged; allogeneic stem cell transplantation; Article; blood; cancer specific survival; chronic graft versus host disease; cohort analysis; controlled study; female; graft versus host reaction; human; incidence; Karnofsky Performance Status; major clinical study; male; matched unrelated donor; mixed phenotype acute leukemia; myeloablative conditioning; overall survival; peripheral blood stem cell; phenotype; recurrence free survival; relapse; remission; retrospective study; T cell depletion; adolescent; allotransplantation; hematopoietic s

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