TY - JOUR
T1 - Outcomes after Second Hematopoietic Cell Transplantation in Children and Young Adults with Relapsed Acute Leukemia
AU - Lund, Troy C.
AU - Ahn, Kwang Woo
AU - Tecca, Heather R.
AU - Hilgers, Megan V.
AU - Abdel-Azim, Hisham
AU - Abraham, Allistair
AU - Diaz, Miguel Angel
AU - Badawy, Sherif M.
AU - Broglie, Larisa
AU - Brown, Valerie
AU - Dvorak, Christopher C.
AU - Gonzalez-Vicent, Marta
AU - Hashem, Hasan
AU - Hayashi, Robert J.
AU - Jacobsohn, David A.
AU - Kent, Michael W.
AU - Li, Chi kong
AU - Margossian, Steven P.
AU - Martin, Paul L.
AU - Mehta, Parinda
AU - Myers, Kasiani
AU - Olsson, Richard
AU - Page, Kristin
AU - Pulsipher, Michael A.
AU - Shaw, Peter J.
AU - Smith, Angela R.
AU - Triplett, Brandon M.
AU - Verneris, Michael R.
AU - Eapen, Mary
N1 - Publisher Copyright:
© 2018
PY - 2019/2
Y1 - 2019/2
N2 - Children with acute leukemia who relapse after hematopoietic cell transplantation (HCT) have few therapeutic options. We studied 251 children and young adults with acute myelogenous or lymphoblastic leukemia who underwent a second HCT for relapse after their first HCT. The median age at second HCT was 11 years, and the median interval between first and second HCT was 17 months. Most of the patients (n = 187; 75%) were in remission, received a myeloablative conditioning regimen (n = 157; 63%), and underwent unrelated donor HCT (n = 230; 92%). The 2-year probability of leukemia-free survival (LFS) was 33% after transplantation in patients in remission, compared with 19% after transplantation in patients not in remission (P =.02). The corresponding 8-year probabilities were 24% and 10% (P =.003). A higher rate of relapse contributed to the difference in LFS. The 2-year probability of relapse after transplantation was 42% in patients in remission and 56% in those in relapse (P =.05). The corresponding 8-year probabilities were 49% and 64% (P =.04). These data extend the findings of others showing that patients with a low disease burden are more likely to benefit from a second transplantation. Late relapse led to a 10% decrement in LFS beyond the second year after second HCT. This differs from first HCT, in which most relapses occur within 2 years after HCT.
AB - Children with acute leukemia who relapse after hematopoietic cell transplantation (HCT) have few therapeutic options. We studied 251 children and young adults with acute myelogenous or lymphoblastic leukemia who underwent a second HCT for relapse after their first HCT. The median age at second HCT was 11 years, and the median interval between first and second HCT was 17 months. Most of the patients (n = 187; 75%) were in remission, received a myeloablative conditioning regimen (n = 157; 63%), and underwent unrelated donor HCT (n = 230; 92%). The 2-year probability of leukemia-free survival (LFS) was 33% after transplantation in patients in remission, compared with 19% after transplantation in patients not in remission (P =.02). The corresponding 8-year probabilities were 24% and 10% (P =.003). A higher rate of relapse contributed to the difference in LFS. The 2-year probability of relapse after transplantation was 42% in patients in remission and 56% in those in relapse (P =.05). The corresponding 8-year probabilities were 49% and 64% (P =.04). These data extend the findings of others showing that patients with a low disease burden are more likely to benefit from a second transplantation. Late relapse led to a 10% decrement in LFS beyond the second year after second HCT. This differs from first HCT, in which most relapses occur within 2 years after HCT.
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U2 - 10.1016/j.bbmt.2018.09.016
DO - 10.1016/j.bbmt.2018.09.016
M3 - Article
C2 - 30244103
AN - SCOPUS:85055126522
SN - 1083-8791
VL - 25
SP - 301
EP - 306
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
IS - 2
ER -