To explore the incidence, risk factors, and outcomes of central nervous system (CNS) relapse after allogeneic hematopoietic stem cell transplantation (allo-HSCT) for acute lymphoblastic leukemia (ALL) and to compare the differences in CNS relapse between haploidentical donor HSCT (HID-HSCT) and HLA-identical sibling donor HSCT (ISD-HSCT). We performed a retrospective nested case-control study on patients with CNS relapse after allo-HSCT. The cumulative incidence of CNS relapse was 4.06% after allo-HSCT in ALL, with a significantly poor prognosis. The incidence was 3.91% and 5.36% in HID-HSCT and ISD-HSCT, respectively (p = .227). Among the patients with CNS relapse, the overall survival (OS) at 3 years was 56.2 ± 6.8% in the HID-HSCT subgroup and 76.9 ± 10.2% in the ISD-HSCT subgroup (p = .176). The 3-year cumulative incidence of systemic relapse was also comparable between the two subgroups (HID-HSCT, 40.6 ± 7.4%; ISD-HSCT, 13.3 ± 8.7%, respectively, p = .085). Younger age (p = .045), T-ALL (p = .035), hyperleukocytosis at diagnosis (p < .001), advanced disease stage at transplant (p < .001), pre-HSCT CNS involvement (p < .001), and absence of chronic graft vs host disease (cGVHD) (p < .001) were independent risk factors for CNS relapse after allo-HSCT. In conclusion, CNS relapse was a significant complication after allo-HSCT in ALL and was associated with poor prognosis. The incidences and outcomes were comparable between HID-HSCT and ISD-HSCT.

探讨同种异体造血干细胞移植 (allo-HSCT) 治疗急性淋巴细胞白血病 (ALL) 后中枢神经系统 (CNS) 复发的发生率、危险因素和结局，并比较半相合供体造血干细胞移植 (HID) 后中枢神经系统 (CNS) 复发的差异-HSCT) 和 HLA 相同的同胞供体 HSCT (ISD-HSCT)。我们对异基因造血干细胞移植后 CNS 复发患者进行了一项回顾性巢式病例对照研究。ALL中allo-HSCT后CNS复发的累积发生率为4.06%，预后明显较差。HID-HSCT 和 ISD-HSCT 的发生率分别为 3.91% 和 5.36% ( p  = .227)。在 CNS 复发患者中，HID-HSCT 亚组的 3 年总生存率为 56.2±6.8%，ISD-HSCT 亚组为 76.9±10.2%（p = .176）。两个亚组之间的 3 年累积全身复发率也相当（HID-HSCT，40.6 ± 7.4%；ISD-HSCT，分别为 13.3 ± 8.7%，p  = .085）。年龄较小 ( p  = .045)、T-ALL ( p  = .035)、诊断时白细胞增多 ( p  < .001)、移植时疾病晚期 ( p  < .001)、HSCT 前 CNS 受累 ( p  < .001) 。 001)，并且没有慢性移植物抗宿主病 (cGVHD)（p < .001) 是 allo-HSCT 后 CNS 复发的独立危险因素。总之，中枢神经系统复发是 ALL 异基因造血干细胞移植后的一个重要并发症，并且与预后不良有关。HID-HSCT 和 ISD-HSCT 的发生率和结果相当。