Outcomes After Second Hematopoietic Cell Transplant for Children and Young Adults with Relapsed Acute Leukemia

Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation. 2018
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Abstract

Children with acute leukemia who relapse after hematopoietic cell transplant (HCT) have few therapeutic options. We studied 251 children and young adults with acute myeloid 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, 17 months. Most (n=187; 75%) were in remission, received myeloablative conditioning regimen (n=157; 63%) and unrelated donor HCT (n=230; 92%). The 2-year probability of leukemia-free survival (LFS) after transplantation in remission was 33% compared to 19% for transplantations that were not in remission (p=0.02). The corresponding 8-year probabilities were 24% and 10% (p=0.003). Higher relapse contributed to the difference in leukemia-free survival. The 2-year probability of relapse for transplantations in remission was 42% compared to 56% for transplantations in relapse (p=0.05). The corresponding 8-year probabilities were 49% and 64% (p=0.04). These data extend the findings of others in that those with low disease burden are more likely to benefit from second transplantation. Late relapse led to a 10% decrement in LFS beyond the second year after second HCT. This differs from first HCT were most relapses occur within 2 years after HCT.

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Language : eng
Credits : Bibliographic data from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine