ArticleBone marrow transplantation2026
Relapse patterns focusing on central nervous system involvement after allogeneic hematopoietic cell transplantation in adult patients with acute lymphoblastic leukemia.
Article in Bone marrow transplantation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- B-Lymphoblastic Leukemia With Isolated Central Nervous System Relapse Mimicking a Vestibular Schwannoma.Clinical case reports · 2026Article
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Authors and funding
14 authors.
Funding
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Abstract
Central nervous system (CNS) relapse remains a clinically significant yet underexplored pattern of recurrence in adult patients with acute lymphoblastic leukemia (ALL) after allogeneic hematopoietic cell transplantation (allo-HCT). We retrospectively analyzed 748 adult ALL patients who underwent allo-HCT between 2009 and 2022 following a modified hyper-CVAD regimen with six planned doses of intrathecal (IT) chemoprophylaxis. Most patients received total body irradiation (TBI)-based conditioning. CNS relapse occurred in 38 (5.1%) patients at a median of 10.6 months post-HCT. Notably, 84.2% of CNS relapses occurred in Philadelphia chromosome (Ph)-positive ALL. Thus, Ph-positive ALL compared to Ph-negative ALL (9.7% vs. 1.4%, p < 0.001) and hyperleukocytosis at diagnosis (8.1% vs. 2.5%, p < 0.001) were associated with CNS relapse. Notably, negative pre-transplant measurable residual disease (MRD) in Ph-positive ALL and prophylactic IT and TBI-based conditioning were associated with reduced CNS relapse risk in Ph-negative ALL. Five-year overall survival of CNS relapse and the other relapse was 30.4% and 7.6%, respectively, and isolated CNS relapse showed the most favorable outcomes. Our findings suggest that Ph-positive ALL with poor molecular response and high initial tumor burden may represent a biologically distinct high-risk subgroup for CNS relapse, warranting novel CNS-directed preventive strategies to improve post-HCT outcomes.
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