Poster # 503 Factors determining outcome of hematopoietic cell transplantation in patients with acute lymphoblastic leukemia at King Faisal specialist hospital and research center, Riyadh, Saudi Arabia

Document Type

Article

Department

Haematology/Oncology

Abstract

Background: Hematopoietic cell transplantation (HCT) is used as a viable treatment option for Acute Lymphoblastic Leukemia (ALL) whose disease demonstrates dismal prognosis with chemotherapy.
Objectives: Determining factors that affect outcome after HCT.
Design/Method: Records of 82 patients with ALL who underwent HCT (2005–2011) were reviewed after approval from institution review board. Data extracted included those related to clinical characteristics of the patients and their outcome.
Results: Forty five patients were male (54.80%). Median age at HCT was 7.46 years (range 0.98–14.31), median time to HCT after diagnosis was 12.56 months. Ten patients were below the age of one year (12%). All patients were in complete remission (CR) at the time of HCT. 40 patients were in CR1, 35 in CR2 and 7 in CR3 at the time of HCT. In 83 transplants, 64 patients received HCT from HLA-identical related donors and 19 from other donors (1 or 2 antigens mismatch cord blood [CB] or one antigen mismatch sibling or related bone marrow [BM]). Stem cell source was BM in 65(78%) and CB in 18(22%). All patients were given myeloablative conditioning regimen. Overall (OS) in our patients was 58.8% and event free survival(EFS) was 54.3%. Median follow-up time for the cohort was 47.2 ± 4.3 months (95%CI: 38.7–55.6) .49 patients were alive with a median follow-up time of 47.2 months (Min: 6.1, Max: 109.9). 17 patients survived for more than 5 years (Min: 61.4, Max: 109.9) months. The cumulative incidence of acute GVHD was 4.8 ± 2.3 and of chronic GVHD was 8.9 ± 3.2. Median time to ANC and platelet recovery was 17 days (range 12–43) and 28 days (range 15–98) respectively. One patient acquired CMV infection after transplant. No one developed VOD, Hemorrhagic cystitis or other complication. Patient's age at HCT and gender, donor‘s HLA status and gender, source of transplant and CR status at HCT did not significantly affect the probability of OS and EFS.
Conclusion: Our results show a favorable outcome to HCT for ALL patients comparable to published data, and no single factor was associated with superior outcome. OS and EFS in cord blood recipient graft is similar to BM recipient graft.

Comments

This work was published before the author joined Aga Khan University

Publication (Name of Journal)

Pediatric Blood & Cancer

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