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2235 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)

Program: Oral and Poster Abstracts
Session: 732. Allogeneic Transplantation: Disease Response and Comparative Treatment Studies: Poster I
Hematology Disease Topics & Pathways:
Biological therapies, Therapies, Transplantation
Saturday, December 9, 2023, 5:30 PM-7:30 PM

Yves Chalandon, MD1, Raynier Devillier, MD, PhD2*, Ariane Boumendil3*, Stéphanie Nguyen Quoc, MD, PhD4*, Claude-Eric Bulabois, MD5*, Patrice Ceballos, MD6*, Eolia Brissot7*, Marie Thérèse Rubio, MD, PhD8*, Hélène Labussière-Wallet, MD9*, Johan Maertens, MD, PhD10*, Patrice Chevallier, MD11, Natacha Maillard, MD12*, Xavier Poiré, MD13*, Cristina Castilla-Llorente, MD14*, Prof. Yves Beguin, MD15*, Jérôme Cornillon, MD16*, Sebastien Maury17*, Tony Marchand, MD18*, Etienne Daguindau19*, Jacques-Olivier Bay, MD, PhD20*, Pascal Turlure, MD21*, Amandine Charbonnier, MD22*, Anne Menard, MD23*, Karin Bilger, MD24*, Gaelle Guillerm25*, Sylvie François, MD26*, Ali Bazarbachi, MD, PhD27, Sylvain Chantepie, MD28*, Philippe Lewalle Sr., MD29*, Ambroise Marcais, MD30*, Michael Loschi, MD, PhD31*, Malek Benakli, MD32*, Paul Chauvet, MD33*, Edouard Forcade, MD, PhD34*, Anne Huynh, MD35*, Marie Robin, MD, PhD36* and Stavroula Masouridi-Levrat, MD37*

1Univ. Hospital of Geneva, Geneva, Switzerland
2Institut Paoli-Calmettes, Marseille, France
3Société Francophone de Greffe de moelle et Thérapie Cellulaire (SFGM-TC), Paris, France
4Hematology Department, Sorbonne Université, Hôpital Pitié-Salpêtrière, APHP, Paris, France
5Hématologie Soins Intensifs, CHU Grenoble Alpes, Grenoble, France
6Clinical Hematology Department, Montpellier University Hospital, MONTPELLIER, France
7Hôpital Saint-Antoine, Sorbonne University, INSERM UMRs 938, Paris, France
8Nancy University Hospital, Vandoeuvre Les Nancy, FRA
9Centre Hospitalier Lyon Sud, Lyon, France
10Department of Hematology, University Hospitals Leuven, Leuven, Belgium
11Service d'hématologie, CHU de Nantes, Nantes, France
12Hematology Department, CHU de Poitiers, Poitiers, France
13Section of hematology, Institut Roi Albert II, Cliniques Universitaires St-Luc, Brussels, Belgium
14Department of Hematology, Gustave Roussy Cancer Campus, Villejuif, France
15Service d'Hématologie, CHU de Liège, Liege, BEL
16Hématologie, CHU de Saint-Etienne, Saint-Etienne, France
17Hematology Department, Hôpitaux universitaires Henri Mondor AP-HP & Université Paris Est Créteil, Créteil, France
18Hematology Department, CHU Rennes, Rennes, France
19Department of Clinical Hematology, CHU de Besançon, Besançon, France
20Service d’hématologie, CHU Clermont-Ferrand, Clermont-Ferrand, France
21Service d'Hématologie Clinique, CHU de Limoges, Limoges, France
22Service d’Hématologie Clinique, Centre Hospitalier Universitaire Amiens-Picardie, Amiens, France
23Centre Henri Becquerel, Rouen, FRA
24Hematology, Institut de Cancerologie Strasbourg Europe (ICANS), Strasbourg, France
25Service d'hématologie, Hôpital Morvan, CHRU Brest, Brest, France
26Maladies du sang, CHU Angers, Angers, France
27American University of Beirut Dept. of Medicine, Beirut, Lebanon
28Institut d'Hématologie, CHU de Caen, Caen, France
29Hôpital Universitaire de Bruxelles (HUB), Institut Jules Bordet, Hematology Department, Brussels, BEL
30Hôpital Necker, AP-HP, PARIS, France
31Centre Hospitalier Universitaire de Nice, Nice, France
32CPMC d’Alger, Alger, Algeria
33Maladies du Sang, Université de Lille,, CHU de Lille,, Lille, FRA
34Service d'Hématologie Clinique et Thérapie Cellulaire, CHU Bordeaux, Pessac, France
35Institut Universitaire du Cancer Toulouse - Oncopole, Toulouse, France
36Hopital Saint Louis, Paris, France
37Hematology Service and Faculty of Medicine, University Hospital of Geneva, Geneva, Switzerland


There are very scarce data regarding the outcome of elderly patients with acute lymphoblastic leukemia (ALL) who received allogeneic hematopoietic stem cell transplantation (alloHSCT) as consolidation therapy in 1rst or higher complete remission (CR). Most studies evaluating the benefit of alloHSCT in ALL include both young and elderly populations. Thus, the optimal conditioning regimen still need to be determined in a frail population represented by patients over 60 years old. In addition, total body irradiation (TBI) dose is of first importance, as prior reports demonstrated its potential higher anti-leukemic effect. We here present the outcome of ALL patients older than 59 years from the Société Francophone de Greffe de Moelle et Thérapie Cellulaire (SFGM-TC) registry.


This is a retrospective study. The primary outcome was overall survival (OS). Secondary outcomes were progression free survival (PFS), non-relapse mortality (NRM), relapse incidence (RI), acute Graft-versus-host disease (aGvHD) grade II-IV, chronic GvHD, neutrophil engraftment and GvHD-free relapse-free survival (GRFS). Competing risks analyses were performed to analyze NRM with competing event relapse, and aGvHD grade II-IV, chronic GvHD and neutrophil engraftment with competing events relapse and death. Univariable analyses were performed using the log-rang test for OS and PFS, while Gray’s test was used for cumulative incidence (CI). Multivariable analyses were performed using the Cox proportional hazards regression model including age, ALL subtype, time from diagnosis to alloHSCT, disease status at alloHSCT, donor to patient CMV status, donor to patient sex, ATG use, myeloablative conditioning (MAC), TBI use.


A total of 316 patients ≥ 60 years old transplanted for ALL from 2012 to 2022 in 36 participating centers were included in this study. Patient’s characteristics are described in Table 1. With a median follow up of 34.5 months (IQR 29.5-38.8), 3-year OS was 46% (95% CI 40-53%) (Figure 1A) with only the disease status at transplant impacting negatively OS, 53% (95% CI 46-60%) in CR1, 32% (95% CI 21-49%) in CR2, 29% (95% CI 13-63%) in advanced disease, p=0.002 and the ALL subtype, 59% (95% CI 51-68%) in Ph+ ALL, 40% (95% CI 29-54%) in Ph- ALL, 34% (95% CI 20-55%) in T-ALL, 20% (95% CI 9-42%) in other/NA, p<0.001. 3-year PFS was 41% (95% CI 35-48%) (Figure 1B) with the disease status at transplant impacting negatively, 49% (95% CI 42-57%) in CR1, 26% (95% CI 16-42%) in CR2, 22% (95% CI 9-58%) in advanced disease, p<0.001, the ALL subtype, 51% (95% CI 42-61%) in Ph+ ALL, 41% (95% CI 31-54%) in Ph- ALL, 21% (95% CI 10-41%) in T-ALL, 21% (95% CI11-43%) in other/NA, p<0.001, year of HSCT worse < 2018, p=0.007, CMV -/- worse, p=0.033, absence of TBI worse, p=0.018. 3-year NRM was 23% (95% CI 18-28%) (Figure 1C) and none of the factors impacted it. 3-year RI was 36% (95% CI 31-42%) (Figure 1D) with the disease status at transplant impacting negatively, 29% (95% CI 23-36%) in CR1, 50% (95% CI 35-63%) in CR2, 56% (95% CI 26-77%) in advanced disease, p=0.0042, the ALL subtype, 26% (95% CI 19-34%) in Ph+ ALL, 43% (95% CI 31-54%) in Ph- ALL, 57% (95% CI 38-73%) in T-ALL, 42% (95% CI 25-59%) in other/NA, p=0.0064, year of HSCT worse < 2018, p=0.0216, CMV -/- worse, p<0.001, absence of TBI worse, p=0.0069, MRD worse, p=0.0111. 3-year GRFS was 30% (95% CI 25-37%) with the disease status at transplant impacting negatively, 35% (95% CI 28-43%) in CR1, 22% (95% CI 13-37%) in CR2, 23% (95% CI 9-59%) in advanced disease, p=0.029, the ALL subtype, 37% (95% CI 30-47%) in Ph+ ALL, 33% (95% CI 23-46%) in Ph- ALL, 15% (95% CI 7-32%) in T-ALL, 17% (95% CI 8-38%) in other/NA, p=0.0029, year of HSCT worse < 2018, p<0.001. CI of aGVHD grade II-IV was 33% (95% CI 28-38%), grade III-IV 11% (95% CI 8-15%), cGVHD 35% (95% CI30-41%), extensive cGVHD 21% (95% CI 16-26%).Multivariable analyses confirmed a worse OS and PFS for advanced disease, with a HR of 1.79 (95% CI 1.22-2.64), p=0.00322 and ALL subtype with a HR for other than Ph+ ALL of 1.99 (95%CI 1.42-2.79).


This study suggests that alloHSCT is a reasonable option for elderly ALL patients without any impact of age but advanced disease and ALL subtype other than Ph+ ALL negatively influenced the outcome.

Disclosures: Chalandon: Novartis: Honoraria, Other: travel support; Incyte: Honoraria, Other: travel support; Sanofi: Other: travel support; BMS: Honoraria, Other: travel support; Janssen: Other: travel support; MSD: Honoraria, Other: travel support; Pfizer: Honoraria; Jazz: Honoraria, Other: travel support, Speakers Bureau; Amgen: Honoraria, Other: travel support; Gilead: Honoraria, Other: travel support; Servier: Honoraria; Abbvie: Honoraria, Other: travel support; Roche: Honoraria, Other: travel support; Astra-Zeneca: Honoraria, Other: travel support. Chevallier: Sanofi: Honoraria; Incyte: Honoraria, Research Funding; Takeda: Honoraria; Mallinckrodt Pharmaceuticals: Honoraria; Immedica Pharma: Honoraria; Servier: Honoraria. Castilla-Llorente: Gilead/Kite: Consultancy, Other: Travel support; Nektar Therapeutics: Consultancy. Marchand: Sobi: Consultancy; Servier: Consultancy, Other: Travel fees; Jazz Pharmaceuticals: Consultancy, Other: travel fees; Astellas: Consultancy. Loschi: Alexion: Honoraria; Sanofi: Honoraria; Gilead: Honoraria; BMS: Honoraria; Sobi: Honoraria; Telios: Honoraria; GSK: Honoraria; Jazz: Honoraria; Kartos: Honoraria; Medac: Honoraria; MSD: Honoraria; Novartis: Honoraria; Pfizer: Honoraria; AstraZeneca: Honoraria. Forcade: GSK: Speakers Bureau; Gilead Sciences: Other: Travel support, Speakers Bureau; Astellas: Speakers Bureau; Alexion: Other: Travel support, Speakers Bureau; Novartis: Consultancy, Other: Travel support, Speakers Bureau; Sanofi: Speakers Bureau; MSD: Other: Travel support. Huynh: Medac: Other: Advisory board; Servier: Other: Advisory board; Astellas: Other: Advisory board; Pfizer: Other: advisory board; Jazz: Other: travel fees, advisory board; Neovii: Other: Advisory board; Novartis: Other: travel fees, advisory board.

*signifies non-member of ASH