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.

• Authors: L M Poon, R Bassett Jr, G Rondon, A Hamdi, M Qazilbash, C Hosing, R B Jones, E J Shpall, U R Popat, Y Nieto, L L Worth, L Cooper, M De Lima, R E Champlin, P Kebriaei
• Journal: Bone marrow transplantation (Bone Marrow Transplant) Vol. 48 Issue 5 Pg. 666-70 (May 2013) ISSN: 1476-5365 [Electronic] England
• PMID: 23085830 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Child
• Female
• Hematopoietic Stem Cell Transplantation (methods)
• Humans
• Male
• Middle Aged
• Precursor Cell Lymphoblastic Leukemia-Lymphoma (drug therapy, surgery)
• Recurrence
• Retrospective Studies
• Treatment Outcome
• Young Adult