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Καταχωρήθηκε: Πέμπτη 07 Απρ 2022
Presenter: Prof. Spyridonidis
Participants: Dr Liga, Dr Tsokanas, E. Sagiadinou, A. Christopoulou Duration: 20 mins


The outcome of refractory/relapsed (R/R) acute leukemias is still dismal and their treatment represents an unmet clinical need.
However, allogeneic transplantation (allo-HSCT) remains the only potentially curative approach in this setting. A prospective study
(GANDALF-01, NCT01814488; EUDRACT:2012-004008-37) on transplantation with alternative donors had been run by GITMO using
a homogeneous myeloablative conditioning regimen with busulfan, thiotepa and fludarabine while GVHD prophylaxis was
stratified by donor type. The study enrolled 101 patients; 90 found an alternative donor and 87 ultimately underwent allo-HSCT.
Two-year overall survival of the entire and of the transplant population (primary endpoint) were 19% and 22%, without significant
differences according to disease, donor type and disease history (relapsed vs refractory patients). Two-year progression-free survival
was 19% and 17% respectively. The cumulative incidences of relapse and non-relapse mortality were 49% and 33% at two years.
Acute grade II-IV and chronic GVHD occurred in 23 and 10 patients. Dose intensification with a myeloablative two-alkylating
regimen as sole strategy for transplanting R/R acute leukemia does seem neither to improve the outcome nor to control disease
relapse. A pre-planned relapse prevention should be included in the transplant strategy in this patient population.

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