Outcomes after Second Hematopoietic Stem Cell Transplantations in Pediatric Patients with Relapsed Hematological Malignancies

Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation
Swati NaikRobert Krance

Abstract

Relapse of hematological malignancies after hematopoietic stem cell transplantation (HCT) is associated with poor prognosis. A second HCT represents one of the few therapeutic options for these high-risk patients. For children undergoing second HCT, the outcome data are particularly limited. We, therefore, conducted a retrospective single-institution study and report the outcomes and prognostic variables associated with overall survival (OS) and relapse in 43 pediatric patients who underwent a second HCT between 2000 and 2013. Eleven of the 43 patients who underwent transplantation remain alive and disease-free at a median follow-up of 49 months (range, 5 to 127 months). The 5-year probability of OS for the entire cohort was 24%. Patients who had early relapse (<6 months) after first HCT had significantly worse OS than those who relapsed late (>6 months), with 5-year OS at 11% versus 34%, respectively (hazard ratio [HR], 2.24; 95% confidence interval [CI], 1.21 to 4.93; P = .013). Active disease at time of second HCT was also associated with a significantly increased risk of relapse (subdistribution hazard ratio [SHR], 2.36; P = .049) for the entire cohort and relapse was the most frequent cause of death (23 of 32; 72%). On sub...Continue Reading

References

Dec 4, 2003·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Soheil MeshinchiJean E Sanders
Jan 16, 2007·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Martha L ArellanoEdmund K Waller
Oct 16, 2014·The New England Journal of Medicine·Shannon L MaudeStephan A Grupp

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Citations

Mar 16, 2016·Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis·Hasan Sami Göksoy, Mutlu Arat
May 18, 2016·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Barbara SpitzerFarid Boulad
Dec 2, 2017·British Journal of Haematology·Michaela KuhlenChristina Peters
Apr 16, 2019·The Journal of Clinical Investigation·David M Barrett
Jun 27, 2020·Blood·Stephen P Hunger, Elizabeth A Raetz
Dec 16, 2020·Pediatric Transplantation·Volkan HazarUNKNOWN Turkish Pediatric Bone Marrow Transplantation Study Group
Sep 24, 2018·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Troy C LundMary Eapen
Mar 21, 2021·Bone Marrow Transplantation·Akshay SharmaBrandon M Triplett

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