Is hematopoietic cell transplantation a good option for those with primary acute lymphoblastic leukemia that has not responded to treatment?

This study aimed to investigate the outcomes of hematopoietic cell transplantation for primary refractory acute lymphoblastic leukemia.

This study concluded that hematopoietic cell transplantation is of benefit to patients with primary refractory acute lymphoblastic leukemia.

Acute lymphoblastic leukemia (ALL) occurs when white blood cells called lymphocytes are overproduced and become abnormal. The abnormal cells called lymphoblasts can kill normal cells and spread through the body. Primary refractory ALL (PREF ALL) occurs when patients have been treated with two or more courses of chemotherapy but complete remission does not occur.

Allogenic hematopoietic stem cell transplant (HCT) can be used as a treatment in PREF ALL patients. In an allogenic transplant, the stem cells come from a donor and are transferred into a PREF ALL patient. These cells can produce lymphocytes in the patient and allow the body to fight cancer.    

It was not known what factors influence the outcome of HCT.

This study involved 86 patients with PREF ALL who underwent HCT between 2000 and 2012. Patients were followed for an average period of 106 months after the HCT.

The chance of survival was 36% at 2 years and 23% at 5 years for PREF ALL patients who uncerwent HCT.

The probability of leukemia-free survival was 28% at 2 years and 17% at 5 years.

The likelihood of death in patients with non-recurring PREF ALL was 20% at 2 years and 29% at 5 years.

77% of all PREF ALL patients who underwent HCT had complete remission (no signs of cancer). Of this group, the survival rate was 36% at 2 years and 29% at 5 years. 

This study concluded that the use of allogenic HCT is beneficial in patients with PREF ALL. However, the authors suggest that new treatments are needed.

This study is missing some data and further in depth studies should be carried out.