Outcomes of second allogeneic hematopoietic stem cell transplantation for patients with acute lymphoblastic leukemia.


Journal Article

For patients with ALL who relapse following allo-SCT, only a second SCT provides a realistic chance for long-term disease remission. We retrospectively analyzed the outcomes of 31 patients with relapsed ALL after a prior allo-SCT, who received a second SCT (SCT2) at our center. With a median follow-up of 3 years, 1- and 3-year PFS was 23 and 11% and 1- and 3 year OS rates were 23 and 11%. Twelve patients (39%) were transplanted with active disease, of whom 75% attained a CR. We found a significant relationship between the time to treatment failure following first allograft (SCT1) and PFS following SCT2 (P=0.02, hazard ratio=0.93/month). In summary, a second transplant remains a potential treatment option for achieving response in a highly refractory patient population. While long-term survival is limited, a significant proportion of patients remains disease-free for up to 1 year following SCT2, providing a window of time to administer preventive interventions. Notably, our four long-term survivors received novel therapies with their second transplant underscoring the need for a fundamental change in the methods for SCT2 to improve outcome.

Full Text

Duke Authors

Cited Authors

  • Poon, LM; Bassett, R; Rondon, G; Hamdi, A; Qazilbash, M; Hosing, C; Jones, RB; Shpall, EJ; Popat, UR; Nieto, Y; Worth, LL; Cooper, L; De Lima, M; Champlin, RE; Kebriaei, P

Published Date

  • May 2013

Published In

Volume / Issue

  • 48 / 5

Start / End Page

  • 666 - 670

PubMed ID

  • 23085830

Pubmed Central ID

  • 23085830

Electronic International Standard Serial Number (EISSN)

  • 1476-5365

Digital Object Identifier (DOI)

  • 10.1038/bmt.2012.195


  • eng

Conference Location

  • England