Stem cell transplant achieves positive outcomes in second remission for adolescents and young adults with ALL
MD Anderson Research News October 14, 2025
A new study from Â鶹ӳ» MD Anderson Cancer Center and Dana-Farber Cancer Institute, published in , found that hematopoietic cell transplantation (HCT) achieves positive outcomes in adolescent and young adult patients with acute lymphoblastic leukemia (ALL) in second remission ¨C meaning these patients are cancer free after a previous relapse.
¡°Stem cell transplants in second remission offer real hope for young ALL patients. By factoring in minimal residual disease (MRD) status and overall health, we can better personalize treatment and improve outcomes,¡± said , one of the principal investigators of the study and professor of Stem Cell Transplantation and Cellular Therapy.
What are the key findings in this research?
The retrospective dual-center study evaluated 164 patients with ALL who received a transplant in second remission at MD Anderson or Dana-Farber between 2010 and 2022. The median patient age was 25 years (range, 15-40 years); 66% of patients were male and 80% had B-lineage ALL. Before the transplant, patients received strong chemotherapy, and most were cancer free at the time of the procedure.
After a median follow-up of 36 months, the three-year overall survival rate was 53%, and the progression-free survival rate was 46%. Relapse and non-relapse mortality rates at three years were 36% and 18%, respectively.
Acute graft-versus-host disease (GVHD) of grades 2¨C4 occurred in 36% of patients, and grades 3-4 occurred in 14% of patients within six months. Chronic GVHD affected 27% of patients at three years, with 37% experiencing moderate forms and 25% severe forms.
What do these findings mean for future ALL treatment options?
With modern frontline therapies and MRD-guided strategies improving survival, HCT is increasingly held during initial remission and reserved for patients who experience a relapse. These findings show that stem cell transplantation can still offer a viable curative approach for these young ALL patients. MRD status and comorbidities significantly impact outcomes, highlighting the importance of personalized, risk-adapted transplant strategies.
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For a full list of collaborating authors and disclosures, see the full paper in .
¡°Stem cell transplants in second remission offer real hope for young ALL patients. By factoring in minimal residual disease (MRD) status and overall health, we can better personalize treatment and improve outcomes."