Photo Credit: Meletios Verras

The following is a summary of “Allogeneic Hematopoietic Stem Cell Transplantation for Elderly Acute Lymphoblastic Leukemia Patients: A Registry Study From the Société Francophone de Greffe de Moelle et Thérapie Cellulaire (SFGM-TC),” published in the May 2025 issue of American Journal of Hematology by Chalandon et al. 

Researchers conducted a retrospective study to evaluate the limited available data on outcomes in older adults (OAs) with acute lymphoblastic leukemia (ALL) who underwent allogeneic hematopoietic stem cell transplantation (alloHSCT). 

They examined 316 patients with ALL aged ≥ 60 years who underwent alloHSCT between 2010 and 2022, using data from the SFGM-TC registry. The study aimed to assess progression-free survival (PFS), non-relapse mortality (NRM), relapse incidence (RI), graft-versus-host disease (GvHD)-free relapse-free survival (GRFS), and associated risk factors. The median age was 63.8 years (range 60–75.8), with 49.8% diagnosed with Philadelphia-positive B-ALL (Ph + ALL), and 70.9% in first complete remission (CR1) at transplant. Donor types included unrelated donors (52.1%), matched related donors (MRD; 26.3%), and haplo-identical donors (17.7%). Reduced-intensity conditioning (RIC) was applied in 64.6% of cases, and total body irradiation (TBI) was given to 35.8%. 

The results showed a 3-year overall survival (OS) of 46% (95% CI 40%–53%), while  PFS, NRM, RI, and GRFS at 3 years were 41% (95% CI 35%–48%), 23% (95% CI 18%–28%), 36% (95% CI 31%–42%), and 30% (95% CI 25%–37%), respectively. Multivariable analysis indicated lower OS and PFS in those with advanced-stage disease, with an HR of 1.79 (95% CI 1.22–2.64; P= 0.0032). The ALL subtype also influenced outcomes, with non-Ph + ALL associated with worse prognosis (HR 1.99; 95% CI 1.42–2.79). 

Investigators concluded that alloHSCT remained a feasible treatment for OAs patients with ALL, although advanced disease and non-Ph + ALL were linked to poorer survival outcomes. 

Source: onlinelibrary.wiley.com/doi/epdf/10.1002/ajh.27701