Faculty Collaboration Database

Outcome of myeloablative conditioning and unrelated donor hematopoietic cell transplantation for childhood acute lymphoblastic leukemia in third remission. Biol Blood Marrow Transplant 2011 Dec;17(12):1833-40

Date

06/21/2011

Pubmed ID

21683798

Pubmed Central ID

PMC3372321

DOI

10.1016/j.bbmt.2011.05.014

Scopus ID

2-s2.0-81255161748 (requires institutional sign-in at Scopus site)   14 Citations

Abstract

We conducted a retrospective study of 155 children who underwent unrelated donor hematopoietic cell transplantation (HCT) between 1990 and 2005 for acute lymphoblastic leukemia in third remission. The median patient age was 11 years, the median time from diagnosis to first relapse was 36 months, and the median time from first relapse to second relapse was 26 months. Stem cell sources were bone marrow (n = 115), peripheral blood (n = 11), and cord blood (n = 29). All patients received a myeloablative pretransplantation conditioning regimen. The 5-year estimates of leukemia-free survival, relapse, and nonrelapse mortality were 30%, 25%, and 45%, respectively. In multivariate analysis, the only risk factor associated with relapse was the interval between the first relapse and the second relapse. Second relapses occurring >26 months from the first relapse were associated with lower risk for post-HCT relapse compared with second relapses occurring at ≤26 months (relative risk, 0.4; P = .01). Relapse risk was lowest when late second relapse was preceded by late first relapse (>36 months from diagnosis), as demonstrated by a 3-year relapse rate of 9% (P = .0009). Our data indicate that long-term leukemia-free survival can be achieved in children with acute lymphoblastic leukemia in third remission using unrelated donor HCT, especially when the second relapse occurs late.

Author List

Nemecek ER, Ellis K, He W, Bunin NJ, Bajwa RS, Cheerva A, Cairo MS, Dvorak C, Duval M, Davies S, Eapen M, Gross TG, Hussein AA, MacMillan ML, Mehta PA, Pulsipher MA, Seber A, Woolfrey AE, Frangoul HA, Carpenter PA

Author

Mary Eapen MBBS, DCh, MRCPI, MS Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Child
Child, Preschool
Disease-Free Survival
Female
Graft vs Host Disease
Hematopoietic Stem Cell Transplantation
Humans
Infant
Male
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Prognosis
Recurrence
Remission Induction
Retrospective Studies
Transplantation Conditioning
Unrelated Donors