Open AccessOutcomes of second allogeneic hematopoietic stem cell transplantation for patients with acute lymphoblastic leukemia
Author(s) -
Limei Poon,
R. Bassett,
Gabriela Rondón,
Amir Hamdi,
Muzaffar H. Qazilbash,
Chitra Hosing,
Roy B. Jones,
Elizabeth J. Shpall,
Uday Popat,
Yago Nieto,
Laura L. Worth,
Laurence J.N. Cooper,
Marcos de Lima,
Richard E. Champlin,
Partow Kebriaei
Publication year - 2012
Publication title -
bone marrow transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.609
H-Index - 127
eISSN - 1476-5365
pISSN - 0268-3369
DOI - 10.1038/bmt.2012.195
Subject(s) - medicine , hematopoietic stem cell transplantation , transplantation , hazard ratio , stem cell , refractory (planetary science) , surgery , population , graft versus host disease , disease , single center , lymphoblastic leukemia , oncology , leukemia , confidence interval , physics , environmental health , biology , astrobiology , genetics
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.