Page 335 - Haematologica Vol. 109 - July 2024

LETTER TO THE EDITOR
with a range of 1-22 years after relapse. In conclusion, CNS relapse after allo-HSCT still has a dismal prognosis with few long-term survivors.
Our study has several limitations: no routine screening for CNS disease at diagnosis at all participating centers, and heterogeneous treatment and conditioning for allo-HSCT. The higher incidence in recent years is probably due to better reporting of CNS relapses.
With current treatment protocols with routine intrathecal chemotherapy and/or prophylaxis, it is difficult to lower relapse rates after allo-HSCT in ALL. In AML, screening for concomitant CNS disease at diagnosis is not routinely performed, and future studies are needed to investigate a possible correlation between CNS infiltration at diagno- sis and relapse after allo-HSCT. Currently, early detection and treatment of CNS relapse after allo-HSCT seems to be the best and only measure to take for this otherwise dismal complication, as our study demonstrates a better outcome in patients with isolated CNS as compared to a combined CNS and BM relapse. There does not seem to be the need to adapt the approach of screening or adding post-transplant prophylaxis based on leukemia subtypes as no difference was detected. However, due to the retro- spective nature of our study, no definite recommendation can be made.
Authors
Sabine Blum,1* Yves Chalandon,2* Myriam Labopin,3 Jürgen Finke,4 Tobias Gedde-Dahl,5 Tarek Ben Othman,6 Jan J. Cornelissen,7 Pavel Jindra,8 Hélène Labussière-Wallet,9 Matthew Collin,10 Stig Lenhoff,11 Guido Kobbe,12 Norma C. Gutiérrez,13 Arnon Nagler14 and Mohamad Mohty15
1Hematology Service, University Hospital and University of Lausanne, Lausanne, Switzerland; 2Division of Hematology and Faculty of Medicine, Geneva University Hospitals and University of Geneva, Geneva, Switzerland; 3Sorbonne University, Department of Hematology, EBMT Paris Study Office, Hôpital Saint Antoine, and INSERM UMRs 938, Paris, France; 4University Hospital of Freiburg, Freiburg, Germany; 5University Hospital Oslo, Oslo, Norway; 6Centre National de Greffe de Moelle, Tunis, Tunisia; 7Erasmus MC Cancer Institute, University Rotterdam, Rotterdam, The Netherlands; 8Charles University Hospital, Pilsen, Czech Republic; 9Hôpital Lyon Sud, Pierre Bénite, France; 10Freeman Hospital, Newcastle Upon Tyne, UK; 11Skanes University Hospital, Lund, Sweden; 12University Hospital Duesseldorf, Heinrich
References
1. Chen Q, Zhu XL, Zhao X, et al. Prognosis and risk factors for central nervous system relapse after allogeneic hematopoietic stem cell transplantation in acute myeloid leukemia. Ann Hematol. 2021;100(2):505-516.
Heine University, Medical Faculty, Duesseldorf, Germany; 13University Hospital of Salamanca, IBSAL, Cancer Research Center-IBMCC (USAL- CSIC), CIBERONC (CB16/12/00233), Salamanca, Spain; 14Chaim Sheba Medical Center, Tel-Hashomer, Israel and 15Sorbonne University, Saint- Antoine Hospital, AP-HP, INSERM UMRs 938, Paris, France
*SB and YC contributed equally as first authors.
Correspondence:
S. BLUM - sabine.blum@chuv.ch
Y. CHALANDON - yves.chalandon@hcuge.ch
https://doi.org/10.3324/haematol.2023.284858
Received: December 15, 2023. Accepted: February 27, 2024. Early view: March 7, 2024.
©2024 Ferrata Storti Foundation Published under a CC BY-NC license
Disclosures
YC reports consulting fees from MSD, Novartis, Incyte, BMS, Pfizer, Abbvie, Roche, Jazz, Gilead, Amgen, Astra-Zeneca, and Servier, and travel support from MSD, Roche, Gilead, Amgen, Incyte, Abbvie, Janssen, Astra-Zeneca, and Jazz. GK reports an Advisory Role or Speaker Honoraria from MSD, Pfizer, Amgen, Novartis, Gilead, BMS- Celgene, Abbvie, Biotest, Takeda, Eurocept, and JAZZ, and Financing of Scientific Research from BMS-Celgene, Amgen, Abbvie, Medac and Eurocept. None of the other authors have any conflicts of interest to disclose.
Contributions
SB, YC and ML wrote the manuscript. ML performed statistical analyses. AN and MM revised the manuscript. SB, YC, JF, TGD, TBO, JJC, PJ, HLW, MC, SL, GK, NCG, AN and MM provided patients and patient follow-up. All authors approved the manuscript before submission.
Funding
This study was supported by a grant from the Ministry of Health of the Czech Republic – Conceptual Development of Research Organization (Faculty Hospital in Pilsen – FNPl, 00669806).
Data-sharing statement
Enquiries for data sharing can be made to the EBMT Acute Leukemia Working Party & Lymphoma Working Party.
2. Tatarian J, Byrd K, Male HJ, Lin TL. Central nervous system involvement in adult acute myeloid leukemia patients. Leuk Res. 2022;118:106882.
3. Del Principe MI, Buccisano F, Soddu S, et al. Involvement of
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