{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T17:26:03Z","timestamp":1769102763311,"version":"3.49.0"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,9,27]],"date-time":"2022-09-27T00:00:00Z","timestamp":1664236800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Allogeneic hematopoietic stem cell transplantation (HSCT) is widely used for high-risk acute lymphoblastic leukemia (ALL) patients in their first complete remission (CR1), and for relapsed patients in second complete remission (CR2).<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and methods<\/jats:title><jats:p>We retrospectively analyzed data for 67 children with ALL, from a cancer center in a low\/middle income country, who had undergone HSCT from human leukocyte antigen (HLA)-matched sibling donors (MSDs) using myeloablative conditioning (MAC) regimens, between 2007 and 2020, describing the survival outcome and relapse probability after achieving CR1 and CR2 and determining outcome differences in relation to indications for HSCT in patients transplanted in CR1. All patients had achieved a negative minimal residual disease prior to transplant (&amp;lt;0.01%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty-six patients (68.7%) were in CR1; 25 had adverse cytogenetics, including 18 patients with Philadelphia chromosome-positive ALL (Ph-positive ALL), and 21 had poor induction response. The 5-year overall survival (OS), event-free survival (EFS) and cumulative incidence of relapse (CIR) for the whole cohort were 56.1% (95% CI, 42.8%-69.4%), 49% (95% CI, 35.7%-62.3%) and 33.5% (95% CI, 21.7%-45.8%), respectively with better EFS and CIR for CR1 transplants compared to CR2 transplants (P=0.02 and P=0.03, respectively). Patients with Ph-positive ALL had better 5-year OS, EFS and non-relapse mortality (NRM) compared with other CR1 transplants (P=0.015, P=0.009 and P=0.028, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Hematopoietic stem cell transplantation from MSD for ALL in CR1 group had superior outcomes compared to CR2 group and was apparently a curable option for Ph-positive ALL without an increased risk of non-relapse mortality. Poorer survival rates and higher relapse probabilities were associated with HSCT conducted to patients who had a poor response to induction therapy or suffered a relapse.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fonc.2022.983220","type":"journal-article","created":{"date-parts":[[2022,9,27]],"date-time":"2022-09-27T05:43:47Z","timestamp":1664257427000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Hematopoietic stem cell transplantation from HLA-matched sibling donors in children with acute lymphoblastic leukemia: A report from the Children\u2019s Cancer Hospital Egypt"],"prefix":"10.3389","volume":"12","author":[{"given":"Mahmoud","family":"Hammad","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanafy","family":"Hafez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iman","family":"Sidhom","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dina","family":"Yassin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sherine","family":"Salem","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khaled","family":"Alsheshtawi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nayera","family":"Hamdy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nahla","family":"Elsharkawy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alaa","family":"Elhaddad","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,9,27]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1007\/s11899-019-00502-2","article-title":"Hematopoietic stem cell transplantation in pediatric acute lymphoblastic leukemia","volume":"14","author":"Merli","year":"2019","journal-title":"Curr Hematol Malig Rep"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2012-02-265884","article-title":"How i treat relapsed childhood acute lymphoblastic leukemia","volume":"120","author":"Locatelli","year":"2012","journal-title":"Blood"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.70.7836","article-title":"Genetic basis of acute lymphoblastic leukemia","volume":"35","author":"Iacobucci","year":"2017","journal-title":"J Clin Oncol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1110169","article-title":"Outcomes after induction failure in childhood acute lymphoblastic leukemia","volume":"366","author":"Schrappe","year":"2012","journal-title":"N Engl J Med"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2008-01-132837","article-title":"Clinical significance of minimal residual disease in childhood acute lymphoblastic leukemia and its relationship to other prognostic factors: A children\u2019s oncology group study","volume":"111","author":"Borowitz","year":"2008","journal-title":"Blood"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2006-07-038299","article-title":"Outcome of treatment in children with hypodiploid acute lymphoblastic leukemia","volume":"110","author":"Nachman","year":"2007","journal-title":"Blood"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2015-09-671131","article-title":"Outcome of children with hypodiploid ALL treated with risk-directed therapy based on MRD levels","volume":"126","author":"Mullighan","year":"2015","journal-title":"Blood"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.18.00822","article-title":"Outcome of children with hypodiploid acute lymphoblastic leukemia: A retrospective multinational study","volume":"37","author":"Pui","year":"2019","journal-title":"J Clin Oncol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1016\/j.clml.2017.03.296","article-title":"Philadelphia-Positive acute lymphoblastic leukemia: Do we still need allogeneic transplantation? 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