Salvage Treatment Options for Post-Transplant Relapse in Children with Early/Very Early Relapse of Acute Lymphoblastic Leukemia: A Single Center Experience

This study aimed to evaluate salvage treatment options for posttransplant relapse in children with early/very early relapse acute lymphoblastic leukemia (ALL). Forty consecutive high-risk ALL children were divided into two groups based on their salvage treatment for posttransplant relapse: Group 1 (n = 9) received purine nucleoside analogs [fludarabine/clofarabine-based regimens], while Group 2 (n = 8) received targeted agents [Blinatumomab, Bortezomib, and CART]. In Group 1, seven children received a fludarabine-based regimen, and two received a clofarabine-based regimen. In Group 2, five children received Bortezomib-based regimens, two received Blinatumomab, and one received CART. Group 2 showed a significantly higher cumulative survival rate (75% vs 22%) and lower grade 3 and 4 toxicity rates (13% vs 66%) compared to Group 1 (p<0.05). Based on our limited data, targeted agents may represent an effective treatment option and can be directly recommended for posttransplant relapse in high-risk children with ALL.