Long-term Results of Allogeneic Hematopoietic Cell Transplantation (allo-HCT): Real-life Data of 15- and 20-year Survivals from a Single Center

Abstract

Allogeneic hematopoietic cell transplantations (allo-HCT) is a procedure with long history and well-documented efficacy in treating various malignant and non-malignant diseases of the hematopoietic system. While there is a potential for late complications even over 10 years following allo-HCT, the data on longer observations are limited due to loss in follow-up, personnel and organizational changes in transplant centers, and focusing on new promising therapies instead of HCT. The study aimed to evaluate 15- and 20-year overall and progression-free survival of allo-HCT recipients in our center. During the inclusion period from 1999 to 2014, we identified 269 allo-HCT recipients. Survival analyses were performed using Kaplan–Meier curves, the Cox proportional hazards model, and the log-rank test. First, we evaluated 15- and 20-year survival rates for the entire cohort of allo-HCT recipients from matched related donor (MRD) and matched unrelated donor (MUD). Then we performed similar analyses for allo-HCT recipients due to acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL), chronic myeloid leukemia (CML), myelodysplastic neoplasms (MDS), non-Hodgkin lymphomas (NHL), and severe aplastic anemia (SAA). It was confirmed that survival benefit continues also during long-term observation. Notably, the plateau effect of PFS was often observed over 20 years following allo-HCT, implying the ability to cure in a relatively large group of patients with otherwise incurable diseases.