ASBMT Statement on Routine Prophylaxis for Central Nervous System Recurrence of Acute Lymphoblastic Leukemia following Allogeneic Hematopoietic Cell Transplantation. Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation Sauter, C. S., DeFilipp, Z., Inamoto, Y., Johnston, L., Nagler, A., Savani, B. N., Carpenter, P. A., Perales, M. 2018


Hematologic malignancies treated with allogeneic hematopoietic cell transplantation (allo-HCT) have varying incidences of posttransplant central nervous system (CNS) relapse, with acute lymphoblastic leukemia (ALL) representing the most common disease histology. While data supporting posttransplant CNS prophylaxis for ALL in the pre-CNS penetrant systemic therapy-era established this as standard practice, controversy exists regarding the role of posttransplant CNS prophylaxis in the contemporary era. Herein we review the most relevant, albeit exclusively retrospective, literature to date for the role of posttransplant CNS prophylaxis in ALL. Given the paucity of data supporting the routine practice of posttransplant CNS prophylaxis for ALL in the contemporary era, this position statement is anticipated to further stoke controversy and discussion within the transplantation community. Ultimately, only well-designed prospective clinical studies will elucidate the role of routine posttransplant CNS prophylaxis.

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