Relapsed ACUTE Leukemia after Hematopoietic STEM CELL Transplantation

BACKGROUND In recent decades the results in the treatment of acute leukemia9s have improved, this due to the optimization of chemotherapy regimens, risk stratification, monitoring of minimal residual disease, development of new agents and best supportive care. Allogeneic hematopoietic stem cell transplantation (HSCT) is a standard option for patients at high risk of relapse. Allogeneic hematopoietic stem cell transplantation (HSCT) is a standard option for patients at high risk relapse. However, patients who relapse after transplantation have a poor prognosis because of subsequent treatments do not confer a success survival. The EBMT has reported a 5.5 months median survival after relapse, overall survival of 8% of ALL and 10-20% to AML to 3 years. AIMS Report outcomes of patients with relapsed acute leukemia after hematopoietic stem cell transplantation (HSCT). METHODS Retrospective analysis of our hematopoietic stem cell transplantation database was undertaken, containing 81 patients with acute leukemia presenting of a period of 10 years. RESULTS We Identified 81 patients, 47 (58%) were men. Median age for ALL was 20 years (7-55 yr) and for AML patients was 34 (15-64yr). ALL was the most frequent diagnosis (61%), 28 patients had AML (35%), other leukemias (4%). 44% patients with ALL had Ph9Chr+. 60% of all patients underwent myeloablative regimen transplantation in first CR and 30% in second remission. The 95% of HSCT was performed allogeneic transplantation and the rest was autologous. In most cases the source of stem cells was peripheral blood. Post-transplant relapse occurred in 51% and 54% of patients with ALL and AML, 10 and 12 months respectively. A total of 6 patients was underwent to second transplant with reduce intensity regimen with very poor response. Table 1 was shows the principal features of patients. CONCLUSION Our results confirm that treatment options for high risk acute leukemic patients who relapse early after HSCT are limited with extremely poor prognosis, special in patient relapsed early post-transplant. More studies are needed to determinate the best treatment option for patient who relapse after HSCT. Disclosures No relevant conflicts of interest to declare.