Outcomes of allogeneic stem cell transplant in adult Philadelphia negative acute lymphoblastic leukemia patients treated with the pediatric-inspired GIMEMA 1913 protocol. A Campus ALL study
Allogeneic hematopoietic stem cell transplantation (alloHSCT) is the best consolidative treatment for high-risk acute lymphoblastic leukemia (ALL). The Campus ALL study group analyzed the clinical outcomes of patients treated in the real-life with the pediatric-inspired and minimal/measurable residual disease (MRD)-oriented GIMEMA LAL1913 protocol who underwent alloHSCT. Key factors impacting on outcomes were MRD and remission status (1<sup>st</sup> complete remission vs 2<sup>nd</sup> complete remission) at transplant. MRD positivity was associated with poorer outcomes, with 3-year overall survival (OS) and disease-free survival (DFS) of 47% and 41% in MRD-positive patients compared to 80% and 70% in MRD-negative patients. Additionally, MRD negativity was associated with improved outcomes also for patients in 2nd complete remission with 3-year OS and DFS rates of 60% and 56%, respectively, compared to only 13% for both outcomes in MRD-positive cases. Patients older than 55 years showed survival rates comparable to younger patients, despite having a slightly higher non-relapse mortality, which remained below 20% at 3 years. These findings underscore the crucial role of alloHSCT in high-risk ALL and emphasize the importance of an early accurate disease risk allocation. The adverse outcome observed with MRD positivity advocates for early pre-transplant intervention with immunotherapy, whenever possible.
Authors
- Fabio Forghieri (ORCID: https://orcid.org/0000-0002-6891-1420)
- Anna Candoni (ORCID: https://orcid.org/0000-0003-4436-1310)
- Valentina Mancini (ORCID: https://orcid.org/0000-0002-1299-233X)
- Robin Foà (ORCID: https://orcid.org/0000-0002-5021-3026)
- Alessandro Cignetti (ORCID: https://orcid.org/0000-0003-2109-1194)
- Michelina Dargenio (ORCID: https://orcid.org/0000-0003-0924-4629)
- Benedetta Cambò (ORCID: https://orcid.org/0000-0001-7091-0438)
- F Valsecchi (ORCID: https://orcid.org/0000-0002-8872-5270)
- Silvia Imbergamo (ORCID: https://orcid.org/0000-0003-4748-2601)
- Federico Mosna (ORCID: https://orcid.org/0000-0001-8979-369X)
- Giorgia Battipaglia (ORCID: https://orcid.org/0000-0002-0695-3879)
- Barbara Scappini
- Chiara Pavoni (ORCID: https://orcid.org/0000-0002-5767-8942)
- Cristina Skert
- Sabina Chiaretti (ORCID: https://orcid.org/0000-0001-8499-4492)
- Patrizia Chiusolo (ORCID: https://orcid.org/0000-0002-1355-1587)
- Marco Cerrano (ORCID: https://orcid.org/0000-0003-1666-3100)
- Cristina Papayannidis (ORCID: https://orcid.org/0000-0001-8705-8333)
- Federico Lussana (ORCID: https://orcid.org/0000-0002-6510-8616)
- Monia Lunghi
- Davide Lazzarotto (ORCID: https://orcid.org/0000-0001-7568-9656)
- Lara Aprile (ORCID: https://orcid.org/0000-0001-6849-0411)
- Giuseppe Lanzarone (ORCID: https://orcid.org/0000-0002-8114-0798)
- Patrizia Zappasodi (ORCID: https://orcid.org/0000-0001-9853-0592)
- Marzia Defina
- Paola Minetto (ORCID: https://orcid.org/0000-0001-6094-4351)
- Massimiliano Bonifacio (ORCID: https://orcid.org/0000-0003-0716-1686)
- Fabio Giglio (ORCID: https://orcid.org/0000-0003-4755-9533)
- Silvia Trappolini
- Anna Grassi (ORCID: https://orcid.org/0000-0002-2806-8336)
- Prassede Salutari
- Crescenza Pasciolla (ORCID: https://orcid.org/0000-0003-4749-9219)
- Mario Delia (ORCID: https://orcid.org/0000-0002-6486-8912)
- Carla Mazzone (ORCID: https://orcid.org/0000-0002-1633-8837)
- Antonino Mulè (ORCID: https://orcid.org/0009-0006-4162-2051)
- Monica Fumagalli (ORCID: https://orcid.org/0000-0002-1962-4548)
- Lidia Santoro
- Endri Mauro
- Nicola Stefano Fracchiolla (ORCID: https://orcid.org/0000-0002-5356-8690)
- Gianluca Cavallaro
- Maria Ilaria Del Principe
Institutions
- University of Rome Tor Vergata (IT)
- University of Verona (IT)
- Università degli Studi del Piemonte Orientale “Amedeo Avogadro” (IT)
- University of Parma (IT)
- University of Milan (IT)
- Agostino Gemelli University Polyclinic (IT)
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (IT)
- Azienda Ospedaliera Citta' della Salute e della Scienza di Torino (IT)
- Ospedale Maggiore (IT)
- Ospedale di Bolzano (IT)
- Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda (IT)
- Azienda Universitaria Ospedaliera Consorziale - Policlinico Bari (IT)
- Ospedale Vincenzo Cervello (IT)
- Azienda Unità Sanitaria Locale di Ferrara (IT)
- Ospedale Papa Giovanni XXIII (IT)
- Azienda Ospedaliero Universitaria Ospedali Riuniti (IT)
- Azienda Ospedaliero-Universitaria di Modena (IT)
- Azienda Ospedaliera San Gerardo (IT)
- Azienda Ospedaliera S.Giuseppe Moscati (IT)
- Azienda Ospedaliero-Universitaria Careggi (IT)
- Federico II University Hospital (IT)
- Istituto di Ematologia di Bologna (IT)
- Azienda Ospedaliero Universitaria Maggiore della Carita (IT)
- Presidio Ospedaliero (IT)
- A. O. Ordine Mauriziano di Torino (IT)
- Istituto Tumori Bari (IT)
- IRCCS Ospedale San Raffaele (IT)
- Azienda Ospedaliera Universitaria Senese (IT)
- St. Eugenio Hospital (IT)
- Ospedale dell' Angelo (IT)
- Azienda Ospedaliera Ospedale Maggiore (IT)
- Ca' Foncello Hospital (IT)
- Ospedale Policlinico San Martino (IT)
- Azienda Ospedale - Università Padova (IT)
- Azienda USL di Pescara (IT)
- Ospedale San Giuseppe (IT)
- Policlinico San Matteo Fondazione (IT)
- Ospedale Vito Fazzi (IT)
- Istituti di Ricovero e Cura a Carattere Scientifico (IT)
- Gruppo Italiano per il Trapianto di Midollo Osseo (IT)
- Ospedali Riuniti Umberto I (IT)
- Sapienza University of Rome (IT)
Publication Details
- Journal
- Bone Marrow Transplantation
- Published
- 2025-06-02
- DOI
- https://doi.org/10.1038/s41409-025-02632-z
- Citations
- 3
- Primary Topic
- Acute Lymphoblastic Leukemia research
- Type
- article
- Field-Weighted Citation Impact
- 5.64