PS1550 ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION CAN OVERCOME THE POOR OUTCOME OF ADULT PH(+) ACUTE LYMPHOBLASTIC LEUKEMIA -- ON BEHALF OF TAIWAN SOCIETY OF BLOOD AND MARROW TRANSPLANTATION

Abstract

Background: Acute lymphoblastic leukemia included Ph(+), Ph-like, and others, and we know that the outcome of Ph(+) ALL was worse as compared with Ph(-). After the introduction of targeted tyrosine kinase inhibitor and allogeneic hematopoietic stem cell transplantation the overall survival improved in historical comparison. Aims: We want to know in real world practice whether the outcome of Ph(+) ALL could be not inferior as compared with Ph(-) after combined TKI and chemotherapy induction therapy followed by allogeneic stem cell transplant. Methods: This is a retrospective study from the data base of Taiwan Society of Blood and Marrow Transplantation (TSBMT) Registry and we compared the overall survival between Ph(+) and Ph(-) ALL. Results: Between 2006 and 2018 we had 526 ALL patients underwent allogeneic hematopoietic stem cell transplantation, with median age of 31 (range 0.7 to 69) and male to female were 55% versus 45%. Pre-transplant disease status included 56% in CR1, 26% in CR2/CR3, 6% were induction failure, and 11% were relapsed patients. Ninty-three (18%) were Ph(+), and 433 (82%) were Ph(-). Seven patient received umbilical cord blood stem cells and 502 (95%) received peripheral blood stem cells, 37 (7%) received bone marrow stem cells, including 26 patients received both bone marrow and peripheral blood stem cells. The overall survival of all patients were 44% at 3 years and 40% at 5 years. For Ph(+) versus Ph(-) patients, 3-year OS were 49% versus 42% and 5-year OS were 49% versus 38%, respectively.Summary/Conclusion: After the introduction of combination of targeted TKI plus chemotherap induction therapy followed by allogeneic stem cell transplantation, the outcome of Ph(+) ALL is not inferior to Ph(-) patients.