Allogeneic Hematopoietic Stem Cell Transplantation for Elderly Acute Lymphoblastic Leukemia Patients: A Registry Study From the Société Francophone de Greffe de Moelle et Thérapie Cellulaire (<scp>SFGM</scp>‐<scp>TC</scp>)

There are very limited data regarding the outcomes of elderly patients with acute lymphoblastic leukemia (ALL) who undergo allogeneic hematopoietic stem cell transplantation (alloHSCT). A total of 316 ALL patients aged ≥ 60 years who underwent alloHSCT between 2010 to 2022 were identified in the SFGM-TC registry. The primary objective was to evaluate progression-free survival (PFS), non-relapse mortality (NRM), relapse incidence (RI), and graft-versus-host disease (GvHD)-free relapse-free survival (GRFS), as well as their risk factors. The median age was 63.8 years (range 60-75.8), 49.8% of patients had Philadelphia-positive B-ALL (Ph + ALL), and 70.9% were in first complete remission (CR1) at transplantation. The donor was an unrelated donor in 52.1%, a matched related donor (MRD) in 26.3%, and a haplo-identical donor in 17.7%. Reduced-intensity conditioning (RIC) was administered to 64.6% of patients, while total body irradiation (TBI) was used in 35.8%. The 3-year overall survival (OS) was 46% (95% CI 40%-53%). The 3-year PFS, NRM, RI, and GRFS were 41% (95% CI 35%-48%), 23% (95% CI 18%-28%), 36% (95% CI 31%-42%), and 30% (95% CI 25%-37%), respectively. Multivariable analyses confirmed poorer OS and PFS in patients with advanced disease, with an HR of 1.79 (95% CI 1.22-2.64), p = 0.0032. Additionally, the ALL subtype significantly impacted outcomes, with an HR of 1.99 (95% CI 1.42-2.79) for non-Ph + ALL. This study suggests that alloHSCT is a viable option for elderly ALL patients, as age itself did not impact outcomes. However, advanced disease and non-Ph + ALL were associated with significantly worse survival.

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Publication Details

Journal
American Journal of Hematology
Published
2025-05-06
DOI
https://doi.org/10.1002/ajh.27701
Citations
2
Primary Topic
Acute Lymphoblastic Leukemia research
Type
article
Field-Weighted Citation Impact
3.76

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article

Allogeneic Hematopoietic Stem Cell Transplantation for Elderly Acute Lymphoblastic Leukemia Patients: A Registry Study From the Société Francophone de Greffe de Moelle et Thérapie Cellulaire (SFGM‐TC)

Ariane Boumendil, Stavroula Masouridi‐Levrat, Éolia Brissot, Marie Robin et al.
2 citations
American Journal of Hematology
Acute Lymphoblastic Leukemia research
3.76
article

Allogeneic Hematopoietic Stem Cell Transplantation for Elderly Acute Lymphoblastic Leukemia Patients: A Registry Study From the Société Francophone de Greffe de Moelle et Thérapie Cellulaire (SFGM‐TC)

Ariane Boumendil, Stavroula Masouridi‐Levrat, Éolia Brissot, Marie Robin, Sébastien Maury, Michael L. Loschi, Paul Chauvet, Sylvain Chantepie, Magalie Joris, Gaëlle Guillerm, Pascal Turlure, Ali Bazarbachi, Patrice Chevallier, Xavier Poiré, Claude‐Eric Bulabois, Étienne Daguindau, Cristina Castilla‐Llorente, Jérôme Cornillon, Yves Béguin, Patrice Céballos, Raynier Devillier, Malek Benakli, Sylvie François, Ambroise Marçais, Yves Chalandon, Hélène Labussière‐Wallet, Johan A. Maertens, Tony Marchand, Édouard Forcade, Stéphanie Nguyen, Philippe Lewalle, Anne‐Lise Ménard, Marie‐Thérèse Rubio, Natacha Maillard, Karin Bilger, Jacques‐Olivier Bay, Anne Huynh
article en
2 citations

Abstract

There are very limited data regarding the outcomes of elderly patients with acute lymphoblastic leukemia (ALL) who undergo allogeneic hematopoietic stem cell transplantation (alloHSCT). A total of 316 ALL patients aged ≥ 60 years who underwent alloHSCT between 2010 to 2022 were identified in the SFGM-TC registry. The primary objective was to evaluate progression-free survival (PFS), non-relapse mortality (NRM), relapse incidence (RI), and graft-versus-host disease (GvHD)-free relapse-free survival (GRFS), as well as their risk factors. The median age was 63.8 years (range 60-75.8), 49.8% of patients had Philadelphia-positive B-ALL (Ph + ALL), and 70.9% were in first complete remission (CR1) at transplantation. The donor was an unrelated donor in 52.1%, a matched related donor (MRD) in 26.3%, and a haplo-identical donor in 17.7%. Reduced-intensity conditioning (RIC) was administered to 64.6% of patients, while total body irradiation (TBI) was used in 35.8%. The 3-year overall survival (OS) was 46% (95% CI 40%-53%). The 3-year PFS, NRM, RI, and GRFS were 41% (95% CI 35%-48%), 23% (95% CI 18%-28%), 36% (95% CI 31%-42%), and 30% (95% CI 25%-37%), respectively. Multivariable analyses confirmed poorer OS and PFS in patients with advanced disease, with an HR of 1.79 (95% CI 1.22-2.64), p = 0.0032. Additionally, the ALL subtype significantly impacted outcomes, with an HR of 1.99 (95% CI 1.42-2.79) for non-Ph + ALL. This study suggests that alloHSCT is a viable option for elderly ALL patients, as age itself did not impact outcomes. However, advanced disease and non-Ph + ALL were associated with significantly worse survival.

American Journal of HematologyVol. 100(7)
University of Geneva (CH), Hôpital Necker-Enfants Malades (FR), Cliniques Universitaires Saint-Luc (BE), Inserm (FR), Université Paris Cité (FR), Université de Lille (FR), Universitair Ziekenhuis Leuven (BE), Centre Hospitalier Universitaire de Grenoble (FR), Institut Jules Bordet (BE), Institut Gustave Roussy (FR), Centre Hospitalier Universitaire de Bordeaux (FR), Centre Hospitalier Universitaire de Lille (FR), Centre Hospitalier Universitaire de Nice (FR), Centre Hospitalier Universitaire de Nantes (FR), Sorbonne Université (FR), Centre Hospitalier Universitaire de Besançon (FR), Centre Hospitalier Universitaire de Montpellier (FR), Centre Hospitalier Universitaire Amiens-Picardie (FR), Assistance Publique – Hôpitaux de Paris (FR), Institut universitaire du cancer de Toulouse Oncopole (FR), Centre Hospitalier Régional et Universitaire de Nancy (FR), University Hospital of Geneva (CH), Centre Hospitalier Universitaire de Poitiers (FR), Centre Hospitalier Universitaire d'Angers (FR), Centre Hospitalier Universitaire de Caen Normandie (FR), Hôpital Nord (FR), Pitié-Salpêtrière Hospital (FR), Centre Hospitalier Universitaire de Clermont-Ferrand (FR), Hôpitaux Universitaires Henri-Mondor (FR), Centre Hospitalier Régional Universitaire de Brest (FR), Centre Hospitalier Universitaire de Liège (BE), Centre de Recherche Saint-Antoine (FR), Centre de Recherche Nucléaire d’Alger (DZ), Hôpital Saint-Louis (FR), Hôpitaux Universitaires de Strasbourg (FR), Institut Paoli-Calmettes (FR), Centre Hospitalier Universitaire de Rennes (FR), Centre Hospitalier Universitaire de Saint-Étienne (FR), Université de Limoges (FR), American University of Beirut (LB), Université de Caen Normandie (FR)
Pfizer, Sanofi, Gilead Sciences, Alexion Pharmaceuticals, BeiGene, Astellas Pharma, Servier, Medac
No poverty
Openalex Percentile: Top 8%
Acute Lymphoblastic Leukemia research
3.76
DOIOpen Access PDFOpenAlex
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