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

Troy C. Lund, Kwang Woo Ahn, Heather R. Tecca, Megan V. Hilgers, Hisham Abdel-Azim, Allistair Abraham, Miguel Angel Diaz, Sherif M. Badawy, Larisa Broglie, Valerie Brown, Christopher C. Dvorak, Marta Gonzalez-Vicent, Hasan Hashem, Robert J. Hayashi, David A. Jacobsohn, Michael W. Kent, Chi kong Li, Steven P. Margossian, Paul L. Martin, Parinda MehtaKasiani Myers, Richard Olsson, Kristin Page, Michael A. Pulsipher, Peter J. Shaw, Angela R. Smith, Brandon M. Triplett, Michael R. Verneris, Mary Eapen

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)301-306
Number of pages6
JournalBiology of Blood and Marrow Transplantation
Volume25
Issue number2
DOIs
StatePublished - Feb 2019

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Cell Transplantation
Young Adult
Leukemia
Recurrence
Transplantation
Survival
Unrelated Donors
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Acute Myeloid Leukemia

All Science Journal Classification (ASJC) codes

  • Hematology
  • Transplantation

Cite this

Lund, Troy C. ; Ahn, Kwang Woo ; Tecca, Heather R. ; Hilgers, Megan V. ; Abdel-Azim, Hisham ; Abraham, Allistair ; Diaz, Miguel Angel ; Badawy, Sherif M. ; Broglie, Larisa ; Brown, Valerie ; Dvorak, Christopher C. ; Gonzalez-Vicent, Marta ; Hashem, Hasan ; Hayashi, Robert J. ; Jacobsohn, David A. ; Kent, Michael W. ; Li, Chi kong ; Margossian, Steven P. ; Martin, Paul L. ; Mehta, Parinda ; Myers, Kasiani ; Olsson, Richard ; Page, Kristin ; Pulsipher, Michael A. ; Shaw, Peter J. ; Smith, Angela R. ; Triplett, Brandon M. ; Verneris, Michael R. ; Eapen, Mary. / Outcomes after Second Hematopoietic Cell Transplantation in Children and Young Adults with Relapsed Acute Leukemia. In: Biology of Blood and Marrow Transplantation. 2019 ; Vol. 25, No. 2. pp. 301-306.
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title = "Outcomes after Second Hematopoietic Cell Transplantation in Children and Young Adults with Relapsed Acute Leukemia",
abstract = "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.",
author = "Lund, {Troy C.} and Ahn, {Kwang Woo} and Tecca, {Heather R.} and Hilgers, {Megan V.} and Hisham Abdel-Azim and Allistair Abraham and Diaz, {Miguel Angel} and Badawy, {Sherif M.} and Larisa Broglie and Valerie Brown and Dvorak, {Christopher C.} and Marta Gonzalez-Vicent and Hasan Hashem and Hayashi, {Robert J.} and Jacobsohn, {David A.} and Kent, {Michael W.} and Li, {Chi kong} and Margossian, {Steven P.} and Martin, {Paul L.} and Parinda Mehta and Kasiani Myers and Richard Olsson and Kristin Page and Pulsipher, {Michael A.} and Shaw, {Peter J.} and Smith, {Angela R.} and Triplett, {Brandon M.} and Verneris, {Michael R.} and Mary Eapen",
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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, CK, Margossian, SP, Martin, PL, Mehta, P, Myers, K, Olsson, R, Page, K, Pulsipher, MA, Shaw, PJ, Smith, AR, Triplett, BM, Verneris, MR & Eapen, M 2019, 'Outcomes after Second Hematopoietic Cell Transplantation in Children and Young Adults with Relapsed Acute Leukemia', Biology of Blood and Marrow Transplantation, vol. 25, no. 2, pp. 301-306. https://doi.org/10.1016/j.bbmt.2018.09.016

Outcomes after Second Hematopoietic Cell Transplantation in Children and Young Adults with Relapsed Acute Leukemia. / Lund, Troy C.; Ahn, Kwang Woo; Tecca, Heather R.; Hilgers, Megan V.; Abdel-Azim, Hisham; Abraham, Allistair; Diaz, Miguel Angel; Badawy, Sherif M.; Broglie, Larisa; Brown, Valerie; Dvorak, Christopher C.; Gonzalez-Vicent, Marta; Hashem, Hasan; Hayashi, Robert J.; Jacobsohn, David A.; Kent, Michael W.; Li, Chi kong; Margossian, Steven P.; Martin, Paul L.; Mehta, Parinda; Myers, Kasiani; Olsson, Richard; Page, Kristin; Pulsipher, Michael A.; Shaw, Peter J.; Smith, Angela R.; Triplett, Brandon M.; Verneris, Michael R.; Eapen, Mary.

In: Biology of Blood and Marrow Transplantation, Vol. 25, No. 2, 02.2019, p. 301-306.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Outcomes after Second Hematopoietic Cell Transplantation in Children and Young Adults with Relapsed Acute Leukemia

AU - Lund, Troy C.

AU - Ahn, Kwang Woo

AU - Tecca, Heather R.

AU - Hilgers, Megan V.

AU - Abdel-Azim, Hisham

AU - Abraham, Allistair

AU - Diaz, Miguel Angel

AU - Badawy, Sherif M.

AU - Broglie, Larisa

AU - Brown, Valerie

AU - Dvorak, Christopher C.

AU - Gonzalez-Vicent, Marta

AU - Hashem, Hasan

AU - Hayashi, Robert J.

AU - Jacobsohn, David A.

AU - Kent, Michael W.

AU - Li, Chi kong

AU - Margossian, Steven P.

AU - Martin, Paul L.

AU - Mehta, Parinda

AU - Myers, Kasiani

AU - Olsson, Richard

AU - Page, Kristin

AU - Pulsipher, Michael A.

AU - Shaw, Peter J.

AU - Smith, Angela R.

AU - Triplett, Brandon M.

AU - Verneris, Michael R.

AU - Eapen, Mary

PY - 2019/2

Y1 - 2019/2

N2 - 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.

AB - 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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