1
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Sadowska-Klasa A, Zaucha JM, Labopin M, Bourhis JH, Blaise D, Yakoub-Agha I, Salmenniemi U, Passweg J, Fegueux N, Schroeder T, Giebel S, Brissot E, Ciceri F, Mohty M. Allogeneic hematopoietic cell transplantation is equally effective in secondary acute lymphoblastic leukemia (ALL) compared to de-novo ALL-a report from the EBMT registry. Bone Marrow Transplant 2024; 59:387-394. [PMID: 38195982 DOI: 10.1038/s41409-023-02192-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 12/16/2023] [Accepted: 12/20/2023] [Indexed: 01/11/2024]
Abstract
Secondary acute lymphoblastic leukemia (s-ALL) comprises up to 10% of ALL patients. However, data regarding s-ALL outcomes is limited. To answer what is the role of allogeneic hematopoietic cell transplantation (HCT) in s-ALL, a matched-pair analysis in a 1:2 ratio was conducted to compare outcomes between s-ALL and de novo ALL (dn-ALL) patients reported between 2000-2021 to the European Society for Blood and Marrow Transplantation registry. Among 9720 ALL patients, 351 (3.6%) were s-ALL, of which 80 were in first complete remission (CR1) with a known precedent primary diagnosis 58.8% solid tumor (ST), 41.2% hematological diseases (HD). The estimated 2-year relapse incidence (RI) was 19.1% (95%CI: 11-28.9), leukemia-free survival (LFS) 52.1% (95%CI: 39.6-63.2), non-relapse mortality (NRM) 28.8% (95%CI: 18.4-40), GvHD-free, relapse-free survival (GRFS) 39.4% (95%CI: 27.8-50.7), and overall survival (OS) 60.8% (95%CI: 47.9-71.4), and did not differ between ST and HD patients. In a matched-pair analysis, there was no difference in RI, GRFS, NRM, LFS, or OS between s-ALL and dn-ALL except for a higher incidence of chronic GvHD (51.9% vs. 31.4%) in s-ALL. To conclude, patients with s-ALL who received HCT in CR1 have comparable outcomes to patients with dn-ALL.
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Affiliation(s)
- A Sadowska-Klasa
- Department of Hematology and Transplantology, Medical University of Gdańsk, Gdańsk, Poland.
| | - J M Zaucha
- Department of Hematology and Transplantology, Medical University of Gdańsk, Gdańsk, Poland.
| | - M Labopin
- Department of Hematology, Sorbonne University, Hopital Saint Antoine, Paris, France
| | - J H Bourhis
- Department of Hematology, Gustave Roussy Cancer Campus, BMT Service, Villejuif, France
| | - D Blaise
- Programme de Transplantation & Therapie Cellulaire, Centre de Recherche en Cancérologie de Marseille, Institut Paoli Calmettes, Marseille, France
| | - I Yakoub-Agha
- CHU de Lille, LIRIC, INSERM U995, Université de Lille, Lille, France
| | - U Salmenniemi
- HUCH Comprehensive Cancer Center, Stem Cell Transplantation Unit, Helsinki, Finland
| | - J Passweg
- University Hospital, Hematology, Basel, Switzerland
| | - N Fegueux
- CHU Lapeyronie, Département d'Hématologie Clinique, Montpellier, France
| | - T Schroeder
- Department of Bone Marrow Transplantation, University Hospital, Essen, Germany
| | - S Giebel
- Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - E Brissot
- Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Sorbonne University, and INSERM UMRs 938, Paris, France
| | - F Ciceri
- Ospedale San Raffaele, Haematology and BMT, Milan, Italy
| | - M Mohty
- Department of Hematology, Sorbonne University, Hopital Saint Antoine, Paris, France
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2
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Riazat-Kesh YJRA, Mascarenhas J, Bar-Natan M. 'Secondary' acute lymphoblastic/lymphocytic leukemia - done playing second fiddle? Blood Rev 2023; 60:101070. [PMID: 36894417 DOI: 10.1016/j.blre.2023.101070] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 02/25/2023] [Accepted: 02/27/2023] [Indexed: 03/08/2023]
Abstract
Acute lymphoblastic/lymphocytic leukemia (ALL) occurring post-cancer diagnosis (secondary ALL - sALL) is increasingly recognized as a discrete entity, constituting up to as much as 5-10% of all new ALL diagnoses, and carrying its own biologic, prognostic and therapeutic significance. In this review, we will outline the history and current state of research into sALL. We will explore the evidence for differences underlining its existence as a distinct subgroup, as well as examining what might be driving such differences etiologically, including prior chemotherapy. We will examine these distinctions on population-, chromosomal-, and molecular-levels, and we will consider whether they translate to differences in clinical outcome, and whether they do - or should - warrant differences in treatment selection.
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Affiliation(s)
| | - John Mascarenhas
- Ruttenberg Treatment Center, Tisch Cancer Institute, 1470 Madison Avenue, 3rd Floor, New York, NY, 10029., United States of America.
| | - Michal Bar-Natan
- Ruttenberg Treatment Center, Tisch Cancer Institute, 1470 Madison Avenue, 3rd Floor, New York, NY, 10029., United States of America.
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3
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Finke J, Schmoor C, Stelljes M, Burchert A, Dreger P, Hegenbart U, Wagner-Drouet EM, Bornhäuser M, Sohlbach K, Schub N, Reicherts C, Kobbe G, Glass B, Bertz H, Grishina O. Thiotepa-fludarabine-treosulfan conditioning for 2nd allogeneic HCT from an alternative unrelated donor for patients with AML: a prospective multicenter phase II trial. Bone Marrow Transplant 2022; 57:1664-1670. [PMID: 35982219 DOI: 10.1038/s41409-022-01777-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 07/29/2022] [Accepted: 08/03/2022] [Indexed: 11/09/2022]
Abstract
Therapeutic options for patients with AML relapsing after allogeneic HCT range from chemotherapy or hypomethylating agents with or without donor lymphocyte infusions to a 2nd allogeneic HCT. Available data are based on retrospective single center or registry studies. The aim of this multicenter trial was to investigate prospectively intensive conditioning with Thiotepa, Fludarabine and Treosulfan (TFT) for 2nd allogeneic HCT from an alternative unrelated donor in patients with AML relapse > 6 months after a 1st allogeneic HCT. Primary endpoint was disease-free survival (DFS) at one year after 2nd HCT. 50 patients median age 53.5 years, in CR/PR (34%) or active relapse (66%) were included. 33 of 38 patients (86.8%) with available data achieved CR 100 days post transplant. 23 patients were alive and free of relapse at primary endpoint one year after 2nd HCT (DFS rate 0.46, 95%-CI (0.32-0.61). Three-year rates of DFS, relapse, non-relapse mortality, and overall survival were 0.24, 95%-CI (0.13-0.36); 0.36 (0.25-0.52); 0.40 (0.29-0.57); and 0.24 (0.13-0.37). Second HCT with TFT conditioning is feasible and has high anti-leukemic efficacy in chemosensitive or refractory AML relapse after prior allogeneic HCT. Still, relapse rates and NRM after 2nd allogeneic HCT remain a challenge. The trial is registered in the German Clinical Trials Registry (number DRKS00005126).
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Affiliation(s)
- Jürgen Finke
- Department of Hematology, Oncology and Stem Cell Transplantation, Faculty of Medicine and Medical Center-University of Freiburg, Freiburg, Germany.
| | - Claudia Schmoor
- Clinical Trials Unit, Faculty of Medicine and Medical Center-University of Freiburg, Freiburg, Germany
| | - Matthias Stelljes
- Department of Medicine A, Hematology and Oncology, University of Muenster, Münster, Germany
| | - Andreas Burchert
- Department of Internal Medicine, Hematology, Oncology and Immunology, Philipps University Marburg and University Hospital Gießen and Marburg, Campus Marburg, Marburg, Germany
| | - Peter Dreger
- Department of Medicine V, University of Heidelberg, Heidelberg, Germany
| | - Ute Hegenbart
- Department of Medicine V, University of Heidelberg, Heidelberg, Germany
| | - Eva-Maria Wagner-Drouet
- Medical Department III, Hematology, Medical Oncology and Pneumology, University Mainz, Mainz, Germany
| | - Martin Bornhäuser
- Medical Department I, University Hospital Carl Gustav Carus, Technische Universitat Dresden, Dresden, Germany
| | - Kristina Sohlbach
- Department of Internal Medicine, Hematology, Oncology and Immunology, Philipps University Marburg and University Hospital Gießen and Marburg, Campus Marburg, Marburg, Germany
| | - Natalie Schub
- Division of Stem Cell Transplantation and Immunotherapy, 2nd Department of Medicine, University of Kiel, Kiel, Germany
| | - Christian Reicherts
- Department of Medicine A, Hematology and Oncology, University of Muenster, Münster, Germany
| | - Guido Kobbe
- Medical Faculty, University Hospital Düsseldorf, Heinrich Heine University, Düsseldorf, Germany
| | - Bertram Glass
- Department of Hematology, Oncology and Stem Cell Transplantation, Asklepios Klinik St Georg, Hamburg, Germany
| | - Hartmut Bertz
- Department of Hematology, Oncology and Stem Cell Transplantation, Faculty of Medicine and Medical Center-University of Freiburg, Freiburg, Germany
| | - Olga Grishina
- Clinical Trials Unit, Faculty of Medicine and Medical Center-University of Freiburg, Freiburg, Germany
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4
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Sadowska-Klasa A, Abba M, Gajkowska-Kulik J, Zaucha JM. Therapy-related acute lymphoblastic leukemia following treatment for multiple myeloma - diagnostic and therapeutic dilemma. Acta Oncol 2022; 61:1126-1131. [PMID: 35668607 DOI: 10.1080/0284186x.2022.2083921] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Alicja Sadowska-Klasa
- Department of Hematology and Transplantology, Medical University of Gdańsk, Gdansk, Poland
| | - Mary Abba
- Medical University of Gdańsk, Gdansk, Poland
| | - Justyna Gajkowska-Kulik
- Department of Hematology and Bone Marrow Transplantation, SSM Nicolaus Copernicus, Toruń, Poland
| | - Jan Maciej Zaucha
- Department of Hematology and Transplantology, Medical University of Gdańsk, Gdansk, Poland
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Parrondo RD, Rahman ZA, Heckman MG, Wieczorek M, Jiang L, Alkhateeb HB, Litzow MR, Greipp P, Sher T, Bergsagel L, Fonseca R, Roy V, Dispenzieri A, Kharfan-Dabaja MA, Murthy HS, Ailawadhi S, Foran JM. Unique characteristics and outcomes of therapy-related acute lymphoblastic leukemia following treatment for multiple myeloma. Blood Cancer J 2022; 12:87. [PMID: 35650175 PMCID: PMC9160012 DOI: 10.1038/s41408-022-00680-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 05/09/2022] [Indexed: 12/14/2022] Open
Affiliation(s)
- Ricardo D. Parrondo
- grid.417467.70000 0004 0443 9942Division of Hematology-Oncology and Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, FL USA
| | - Zaid Abdel Rahman
- grid.240145.60000 0001 2291 4776Stem Cell Transplantation and Cellular Therapies, MD Anderson Cancer Center, Houston, TX USA
| | - Michael G. Heckman
- grid.417467.70000 0004 0443 9942Division of Clinical Trials and Biostatistics, Mayo Clinic, Jacksonville, FL USA
| | - Mikolaj Wieczorek
- grid.417467.70000 0004 0443 9942Division of Clinical Trials and Biostatistics, Mayo Clinic, Jacksonville, FL USA
| | - Liuyan Jiang
- grid.417467.70000 0004 0443 9942Department of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, FL USA
| | - Hassan B. Alkhateeb
- grid.66875.3a0000 0004 0459 167XDivision of Hematology, Mayo Clinic, Rochester, MN USA
| | - Mark R. Litzow
- grid.66875.3a0000 0004 0459 167XDivision of Hematology, Mayo Clinic, Rochester, MN USA
| | - Patricia Greipp
- grid.66875.3a0000 0004 0459 167XDepartment of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN USA
| | - Taimur Sher
- grid.417467.70000 0004 0443 9942Division of Hematology-Oncology and Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, FL USA
| | - Leif Bergsagel
- grid.470142.40000 0004 0443 9766Division of Hematology-Oncology, Mayo Clinic, Phoenix, AZ USA
| | - Rafael Fonseca
- grid.470142.40000 0004 0443 9766Division of Hematology-Oncology, Mayo Clinic, Phoenix, AZ USA
| | - Vivek Roy
- grid.417467.70000 0004 0443 9942Division of Hematology-Oncology and Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, FL USA
| | - Angela Dispenzieri
- grid.66875.3a0000 0004 0459 167XDivision of Hematology, Mayo Clinic, Rochester, MN USA
| | - Mohamed A. Kharfan-Dabaja
- grid.417467.70000 0004 0443 9942Division of Hematology-Oncology and Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, FL USA
| | - Hemant S. Murthy
- grid.417467.70000 0004 0443 9942Division of Hematology-Oncology and Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, FL USA
| | - Sikander Ailawadhi
- grid.417467.70000 0004 0443 9942Division of Hematology-Oncology and Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, FL USA
| | - James M. Foran
- grid.417467.70000 0004 0443 9942Division of Hematology-Oncology and Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, FL USA
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6
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Kallen ME, Koka R, Singh ZN, Ning Y, Kocoglu MH, Badros AZ, Niyongere S, Duong VH, Emadi A, Baer MR. Therapy-related B-lymphoblastic leukemia after multiple myeloma. Leuk Res Rep 2022; 18:100358. [PMID: 36353199 PMCID: PMC9637917 DOI: 10.1016/j.lrr.2022.100358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 09/29/2022] [Accepted: 10/30/2022] [Indexed: 11/07/2022] Open
Abstract
New therapies for multiple myeloma have improved outcomes, but are associated with therapy-related hematologic malignancies. We report eight patients with therapy-related B-lymphoblastic leukemias (t-B-ALL) in the setting of therapy for multiple myeloma, which included lenalidomide maintenance. A subset of patients had pancytopenia and low-level marrow involvement by acute leukemia, an unusual finding in de novo B-ALL. One patient died of chemotherapy complications; the other seven responded. No patient died of B-ALL (median follow up of 1.0 years). Our series suggests that t-B-ALL is clonally unrelated to myeloma, presents with diverse cytogenetic abnormalities, and responds well to B-ALL therapy.
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Affiliation(s)
- Michael E. Kallen
- Department of Pathology, University of Maryland School of Medicine, Baltimore, MD, United States
- Corresponding author at: Department of Pathology, University of Maryland School of Medicine, 22 S. Greene St., NBW-54, 21201, Baltimore, MD.
| | - Rima Koka
- Department of Pathology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Zeba N. Singh
- Department of Pathology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Yi Ning
- Department of Pathology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Mehmet H. Kocoglu
- Department of Medicine, Division of Hematology/Oncology, University of Maryland School of Medicine, Baltimore, MD, United States
- University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, MD, , United States
| | - Ashraf Z. Badros
- Department of Medicine, Division of Hematology/Oncology, University of Maryland School of Medicine, Baltimore, MD, United States
- University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, MD, , United States
| | - Sandrine Niyongere
- Department of Medicine, Division of Hematology/Oncology, University of Maryland School of Medicine, Baltimore, MD, United States
- University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, MD, , United States
| | - Vu H. Duong
- Department of Medicine, Division of Hematology/Oncology, University of Maryland School of Medicine, Baltimore, MD, United States
- University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, MD, , United States
| | - Ashkan Emadi
- Department of Medicine, Division of Hematology/Oncology, University of Maryland School of Medicine, Baltimore, MD, United States
- University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, MD, , United States
| | - Maria R. Baer
- Department of Medicine, Division of Hematology/Oncology, University of Maryland School of Medicine, Baltimore, MD, United States
- University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, MD, , United States
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