Faculty Collaboration Database

Outcomes after Second Hematopoietic Cell Transplantation in Children and Young Adults with Relapsed Acute Leukemia. Biol Blood Marrow Transplant 2019 Feb;25(2):301-306

Date

09/24/2018

Pubmed ID

30244103

Pubmed Central ID

PMC6339844

DOI

10.1016/j.bbmt.2018.09.016

Scopus ID

2-s2.0-85055126522 (requires institutional sign-in at Scopus site)   26 Citations

Abstract

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.

Author List

Lund TC, Ahn KW, Tecca HR, Hilgers MV, Abdel-Azim H, Abraham A, Diaz MA, Badawy SM, Broglie L, Brown V, Dvorak CC, Gonzalez-Vicent M, Hashem H, Hayashi RJ, Jacobsohn DA, Kent MW, Li CK, Margossian SP, Martin PL, Mehta P, Myers K, Olsson R, Page K, Pulsipher MA, Shaw PJ, Smith AR, Triplett BM, Verneris MR, Eapen M

Authors

Kwang Woo Ahn PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin
Larisa Broglie MD, MS Assistant Professor in the Pediatrics department at Medical College of Wisconsin
Mary Eapen MBBS, DCh, MRCPI, MS Professor in the Medicine department at Medical College of Wisconsin
Kristin Page MD, MHS, MEd Associate Professor in the Pediatrics department at Medical College of Wisconsin

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

Acute Disease
Adolescent
Adult
Child
Child, Preschool
Disease-Free Survival
Female
Hematopoietic Stem Cell Transplantation
Humans
Infant
Leukemia
Male
Recurrence
Survival Rate
Time Factors
Young Adult