BloodThe Role of Allogeneic Transplant for Adult Ph+ ALL in CR1 with Complete Molecular Remission: A Retrospective Analysis

Acute lymphoblastic leukemia (ALL) with Philadelphia chromosome positivity (Ph+) has a poor prognosis historically, so allogeneic hematopoietic cell transplantation (allo-HCT) is advised after the first complete remission (CR1). The rapid achievement of a complete molecular remission (CMR), however, is associated with excellent outcomes without allo-HCT in the tyrosine kinase inhibitor (TKI) era, indicating transplant may not be necessary for these patients. To test this theory, the authors of this journal-based CME program looked into 5 transplant centers in the US to find adult Ph+ ALL patients who received induction therapy, such as TKIs, and received CMR within 90 days of diagnosis. They then compared the outcomes of people who received allo-HCT in the first remission versus those who did not.