This retrospective single-center study of 333 adults with acute lymphoblastic leukemia (ALL) has found that cytogenetic risk is not an independent predictor of allogeneic hematopoietic cell transplantation (HCT) outcome. Patients were classified according to disease status at HCT (first complete remission (CR1) or >CR1) and cytogenetic risk (good, intermediate, or poor). Disease status at HCT was an independent predictor for leukemia-free survival (LFS) (CR1 vs. others: HR 3.17, p<0.01) and overall survival (OS) (CR1 vs. others: HR 2.90, p<0.01). In multivariate analysis, cytogenetic risk did not affect OS or LFS. The risk of relapse and mortality was significantly increased in HCT beyond CR1 compared to HCT in CR1 (CR1 vs CR2: HR 1.95, p<0.01). The authors conclude that appropriate selection of patients for allogeneic HCT in CR1 remains critical for improving patient outcomes.
Disease Status, Not Cytogenetics, Predict HCT Outcome in Adult ALL