AlloHSCT in paediatric ALL and AML in complete remission: improvement over time impacted by accreditation?

Abstract:

:Allogeneic hematopoietic stem cell transplantation (alloHSCT) has become a well-established treatment option for many patients suffering from malignant and non-malignant diseases. In the past decade, high-resolution HLA-typing, remission surveillance, pre-emptive immune intervention, and standardisation in supportive care measures have substantially improved transplant outcomes. This retrospective study evaluated transplant procedures in 162 paediatric patients with acute lymphoblastic leukaemia (n = 124) or acute myeloid leukaemia (n = 38) who received their first alloHSCT in our institution over an 11-year period. We observed a significant reduction in risk of non-relapse mortality (NRM) over time (HR = 0.34, 95% CI 0.12-0.98; P = 0.05), the 4-year NRM estimate decreased from 20% in 2005-2008 to 7% in 2012-2016 (P = 0.02) and an increase in survival after relapse. There was no significant difference in patients who received a graft from a sibling, haplo, or an unrelated donor with regard to their overall survival (P = 0.45), event-free survival (P = 0.61), and non-relapse mortality (P = 0.19). Our data suggest that a specific transplant infrastructure with a highly experienced team in an accredited transplant centre likely contributes to better transplant outcomes for acute leukaemia patients in complete remission regardless of donor type.

journal_name

Bone Marrow Transplant

authors

Bakhtiar S,Salzmann-Manrique E,Hutter M,Krenn T,Duerken M,Faber J,Reinhard H,Kreyenberg H,Huenecke S,Cappel C,Bremm M,Pfirrmann V,Merker M,Barnbrock A,Schöning S,Willasch AM,Rettinger E,Soerensen J,Klingebiel TE,Jar

doi

10.1038/s41409-018-0341-z

subject

Has Abstract

pub_date

2019-05-01 00:00:00

pages

737-745

issue

5

eissn

0268-3369

issn

1476-5365

pii

10.1038/s41409-018-0341-z

journal_volume

54

pub_type

临床试验,杂志文章