Allogeneic hematopoietic stem cell transplantation for adult patients with B-cell acute lymphoblastic leukemia with high hyperdiploidy: a retrospective nationwide study

Abstract

We compared the transplant outcomes of adult patients with B-cell acute lymphoblastic leukemia characterized by high hyperdiploidy (HeH; 51–65 chromosomes) (n = 29) and those with a normal karyotype (n = 87) by propensity score-matched analysis. There were no significant differences among groups in 3-year probabilities of overall survival (OS, 63.5% vs. 55.3%, p = .553), cumulative relapse incidence (28.6% vs. 28.7%, p = .982), and non-relapse mortality (10.9% vs. 21.4%, p = .303). Three-year OS was significantly worse in HeH patients with third or later complete remission (CR) or non-CR compared with those in first CR (19.0% vs. 69.9%, p = .010). Frequently gained chromosomes +21 (75.9%), +4 (69.0%), +6 (69.0%), +10 (69.0%), and +1 (69.0%) had no significant prognostic impact on the OS of patients with HeH in multivariate analyses. Patients with HeH who may benefit from allogeneic hematopoietic stem cell transplantation should be further analyzed.

Keywords:

• B-cell acute lymphoblastic leukemia
• hematopoietic stem cell transplantation
• hyperdiploidy
• propensity score

Acknowledgments

We are grateful to all physicians and staff at the transplant centers who provided clinical data to the Transplant Registry Unified Management Program of the Japan Society of Hematopoietic Cell Transplantation. We also thank the staff at the Japan Society of Hematopoietic Cell Transplantation and the Japanese Data Center for Hematopoietic Cell Transplantation for their dedication to the organization and management of the data.

Disclosure statement

The authors report no conflict of interest.