Outcomes of allogeneic stem cell transplantation in acute leukemias – single centre study

Abstract

Aim: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is recommended in first complete remission (CR) for adverse and intermediate-risk acute myeloid leukemia (AML) and not recommended for AML patients with favourable disease. Allo-HSCT is standard of care in high-risk acute lymphoblastic leukaemia (ALL) and relapsed ALL but is not indicated for standard-risk ALL. Even though in many studies benefit for survival was proven for these patients, relapse rates (RR) at one year (32.9% for LAM and 34% for LAL) remains problematic. We want to report the outcomes of patients treated for acute leukaemia in our centre. Materials and methods: We conducted a retrospective descriptive analysis of 215 patients with acute leukaemia treated with allo-HSCT between 2017 and 2022 in Fundeni Clinical Institute. Data analysis aimed the overall survival (OS) rate, progression free survival (PFS) and RR at one year based on genetic risk, number of CR, minimal residual disease (MRD) status and conditioning regimen used. Results: At one year evaluation we observed OS rate of 64% and a 34% RR for ALL patients, while AML patients had a 74% OS rate and 13% RR. Conclusions: The results obtained in our centre are similar to the ones reported in literature. The highest risk of relapse and smallest rate of survival are registered for patients who present with negative risk factors. The multifactorial influence over OS and RR impose the need for future studies in which different patient categories can benefit from an optimal therapeutic management.