[Prognostic analysis of allogeneic hematopoietic stem cell transplantation for Philadelphia chromosome-positive acute lymphoblastic leukemia in complete remission in the era of tyrosine kinase inhibitors].

To study the clinical results and prognostic factors for allo-HSCT of Philadelphia chromosome-positive (Ph(+)) acute lymphoblastic leukemia (ALL) in complete remission (CR) in the era of tyrosine kinase inhibitors (TKI) . We performed a retrospective analysis of the clinical characteristics of 116 patients with Ph(+)ALL who underwent allo-HSCT while in CR. The study population included 72 men and 44 women. The median patient age was 20 years (4-64 years) . The patients received sibling-identical donor (=21) , haplo (=77) , and unrelated donor (=18) HSCT. The overall survival (OS) rate at 5 years was 73.2% (95% 63.8% -80.5% ) . In particular, the 5-year OS can reach 87.5% when the time from diagnosis to transplant is <180 days. The 5-years DFS was 61.4% (95% 51.8% -69.7% ) , the 5-year molecular and morphology cumulative relapse incidence was 18.5% (95% 12.6% -27.3% ) , and the 5-year TRM was 19.9% (95% 13.8% -28.7% ) . A multivariate analysis showed that an age range of 15-39 years (=2.730, =0.044) , time from diagnosis to HSCT ≥ 180 days (=4.534, =0.010) , and Ⅲ-Ⅳgrade aGVHD (=7.558, =0.000) were significantly associated with an inferior overall survival. Limited cGVHD subgroup had better OS (=0.300, =0.034) . Sex, WBC count at diagnosis, type of BCR-ABL fusion genes, somatic gene mutations, CR(1) or >CR(1), MRD negative or positive, conditioning regimen based on TBI or Bu, conditioning intensity, donor source, GVHD prophylactic proposal using cyclosporine or tacrolimus, presence/absence of CMV viremia, and presence/absence of EBV viremia were not significantly different in terms of the OS and DFS. Factors influencing the overall survival of Ph(+) ALL patients who underwent allo-HSCT in CR in the TKI era include age, time form diagnosis to HSCT, and aGVHD severity.