Effects of hematological complete remission status before transplantation on outcomes of patients with B-cell acute lymphoblastic leukemia receiving haploidential stem cell transplantation

Zhidong WANG; Yanrong LIU; Yazhe WANG; Wei HAN; Huan CHEN; Yao CHEN; Jingzhi WANG; Xiaodong MO; Yuanyuan ZHANG; Chenhua YAN; Yuhong CHEN; Yu WANG; Lanping XU; Xiaohui ZHANG; Kaiyan LIU; Xiaojun HUANG; Yingjun CHANG

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Effects of hematological complete remission status before transplantation on outcomes of patients with B-cell acute lymphoblastic leukemia receiving haploidential stem cell transplantation

VernacularTitle:移植前血液形态学完全缓解状态对单倍型相合造血干细胞移植治疗B-ALL预后的影响
Author: Zhidong WANG ¹ ; Yanrong LIU ¹ ; Yazhe WANG ¹ ; Wei HAN ¹ ; Huan CHEN ¹ ; Yao CHEN ¹ ; Jingzhi WANG ¹ ; Xiaodong MO ¹ ; Yuanyuan ZHANG ¹ ; Chenhua YAN ¹ ; Yuhong CHEN ¹ ; Yu WANG ¹ ; Lanping XU ¹ ; Xiaohui ZHANG ¹ ; Kaiyan LIU ¹ ; Xiaojun HUANG ¹ ; Yingjun CHANG ¹
Author Information

1. Peking University People′s Hospital & Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation
Publication Type:Journal Article
Keywords: acute lymphoblastic leukemia; hematological complete remission; haploidentical stem cell transplantation; prognosis
From: Chinese Journal of Clinical Laboratory Science 2019;37(11):842-847
CountryChina
Language:Chinese
Abstract: Objective:To investigate the association of hematological complete remssion (HCR) status on the outcomes of the patients with B-cell acute lymphoblastic leukemia (B-ALL) who were undergoing haploidentical stem cell transplantation (Haplo-SCT).
Methods:Retrospective analysis was performed on 317 patients with B-ALL who received Haplo-SCT with HCR before transplantation in the Institute of Hematology, Peking University from September 2012 to June 2016. A Cox proportional hazards model was used to analyze the effects of HCR status before transplantation on the outcomes of Haplo-SCT.
Results:The 3-year cumulative incidences of non-relapse mortality (NRM) and cumulative incidence of relapse (CIR) were 15% and 15%, respectively. The 3-year probabilities of leukemia-free survival (LFS) and overall survival (OS) were 71% and 74%, respectively. There was no statistical difference for 3-year NRM, CIR and LFS among the HCR patients with recovery of absolute neutrophil count (ANC) and platelet (CR) group, without recovery of ANC and with or without recovery of platelet (CRi) group and those in HCR with recovery of ANC but without recovery of platelet (CRp) group (P value ＞0.05 for all). The probability of OS in cases of CR group was significantly higher than that of CRi group (76% vs 59%，P=0.049). Multivariate analysis showed that factors associated with CIR included pre-transplantation minimal residual disease (P=0.006) and chronic GVHD (P=0.020). Platelet engraftment was associated with NRM, LFS, and OS (P＜0.001 for all). Grades Ⅲ-Ⅳ GVHD was associated with NRM (P＜0.001) and OS (P=0.035). Chronic GVHD was correlated with LFS (P＜0.001).
Conclusion:Our results indicate that no effect of HCR status before transplant on the outcomes was observed in patients with B-ALL who underwent Haplo-SCT.