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

Abstract:

: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.

journal_name

Bone Marrow Transplant

authors

Poon LM,Bassett R Jr,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

doi

10.1038/bmt.2012.195

subject

Has Abstract

pub_date

2013-05-01 00:00:00

pages

666-70

issue

5

eissn

0268-3369

issn

1476-5365

pii

bmt2012195

journal_volume

48

pub_type

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