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Outcomes after Second Hematopoietic Cell Transplantation in Children and Young Adults with Relapsed Acute Leukemia.

Publication ,  Journal Article
Lund, TC; Ahn, KW; Tecca, HR; Hilgers, MV; Abdel-Azim, H; Abraham, A; Diaz, MA; Badawy, SM; Broglie, L; Brown, V; Dvorak, CC; Hashem, H ...
Published in: Biol Blood Marrow Transplant
February 2019

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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Published In

Biol Blood Marrow Transplant

DOI

EISSN

1523-6536

Publication Date

February 2019

Volume

25

Issue

2

Start / End Page

301 / 306

Location

United States

Related Subject Headings

  • Young Adult
  • Time Factors
  • Survival Rate
  • Recurrence
  • Male
  • Leukemia
  • Infant
  • Immunology
  • Humans
  • Hematopoietic Stem Cell Transplantation
 

Citation

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Lund, T. C., Ahn, K. W., Tecca, H. R., Hilgers, M. V., Abdel-Azim, H., Abraham, A., … Eapen, M. (2019). Outcomes after Second Hematopoietic Cell Transplantation in Children and Young Adults with Relapsed Acute Leukemia. Biol Blood Marrow Transplant, 25(2), 301–306. https://doi.org/10.1016/j.bbmt.2018.09.016
Lund, Troy C., Kwang Woo Ahn, Heather R. Tecca, Megan V. Hilgers, Hisham Abdel-Azim, Allistair Abraham, Miguel Angel Diaz, et al. “Outcomes after Second Hematopoietic Cell Transplantation in Children and Young Adults with Relapsed Acute Leukemia.Biol Blood Marrow Transplant 25, no. 2 (February 2019): 301–6. https://doi.org/10.1016/j.bbmt.2018.09.016.
Lund TC, Ahn KW, Tecca HR, Hilgers MV, Abdel-Azim H, Abraham A, et al. Outcomes after Second Hematopoietic Cell Transplantation in Children and Young Adults with Relapsed Acute Leukemia. Biol Blood Marrow Transplant. 2019 Feb;25(2):301–6.
Lund, Troy C., et al. “Outcomes after Second Hematopoietic Cell Transplantation in Children and Young Adults with Relapsed Acute Leukemia.Biol Blood Marrow Transplant, vol. 25, no. 2, Feb. 2019, pp. 301–06. Pubmed, doi:10.1016/j.bbmt.2018.09.016.
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 C-K, Margossian SP, Martin PL, Mehta P, Myers K, Olsson R, Page K, Pulsipher MA, Shaw PJ, Smith AR, Triplett BM, Verneris MR, Eapen M. 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.
Journal cover image

Published In

Biol Blood Marrow Transplant

DOI

EISSN

1523-6536

Publication Date

February 2019

Volume

25

Issue

2

Start / End Page

301 / 306

Location

United States

Related Subject Headings

  • Young Adult
  • Time Factors
  • Survival Rate
  • Recurrence
  • Male
  • Leukemia
  • Infant
  • Immunology
  • Humans
  • Hematopoietic Stem Cell Transplantation