Second allogeneic stem cell transplantation in patients with acute lymphoblastic leukaemia: a study on behalf of the Acute Leukaemia Working Party of the European Society for Blood and Marrow Transplantation

Nagler A, Labopin M, Dholaria B, Finke J, Brecht A, Schanz U, Niittyvuopio R, Neubauer A, Bornhäuser M, Santarone S, Beelen D, Shimoni A, Rösler W, Giebel S, Savani BN, Mohty M (2019)

Publication Type: Journal article

Publication year: 2019

Journal

British Journal of Haematology Wiley-Blackwell

DOI: 10.1111/bjh.15973

Abstract

Although second allogeneic haematopoietic cell transplantation (allo-HCT2) is a therapeutic option for patients relapsing after first HCT (allo-HCT1), there is limited data on allo-HCT2 in patients with acute lymphoblastic leukaemia (ALL). We retrospectively studied 245 patients receiving allo-HCT2 as a salvage treatment for relapse following allo-HCT1 between the 2000 and 2017. The median age at allo-HCT2 was 34·6 years (range: 18-74). One hundred and one patients (41%) received sibling donor and 144 (59%) unrelated donor allo-HCT2. Acute graft-versus-host disease (GVHD) grade II-IV and III-IV occurred in 33% and 17% of the patients, respectively. The incidence of 2-year total and extensive chronic GVHD was 38% and 19%, respectively. The 2- and 5-year cumulative incidence of non-relapse mortality, relapse incidence, leukaemia-free survival, overall survival and GVHD-free, relapse-free survival (GRFS) were 24% and 26%, 56% and 62%, 20% and 12%, 30% and 14% and 12% & 7%, respectively. In multivariate analysis, factors associated with overall survival were age, time from allo-HCT1 to relapse, conditioning for allo-HCT1, Karnofsky score at allo-HCT2 and donor type for allo-HCT2. In conclusion, outcomes of allo-HCT2 in ALL patients were poor, with only 14% overall survival and 7% GRFS at 5 years with very high relapse incidence.

Authors with CRIS profile

Wolf Rösler Department of Medicine 5 – Haematology and Oncology

Involved external institutions

Hôpital Saint-Antoine FR France (FR) Maria Skłodowska-Curie Institute of Oncology / Centrum Onkologii–Instytut im. Marii Skłodowskiej-Curie w Warszawie PL Poland (PL) Universitätsspital Zürich (USZ) CH Switzerland (CH) Universitätsklinikum Essen DE Germany (DE) Albert-Ludwigs-Universität Freiburg DE Germany (DE) Tel Aviv University IL Israel (IL) Assistance Publique-Hôpitaux de Paris (AP-HP) FR France (FR) Universitätsklinikum Carl Gustav Carus Dresden DE Germany (DE) Deutsche Klinik für Diagnostik DE Germany (DE) Universitätsklinikum Gießen und Marburg (UKGM) DE Germany (DE) Vanderbilt University US United States (USA) (US) Chaim Sheba Medical Center at Tel HaShomer / המרכז הרפואי עש חיים שיבא – תל השומר‎‎ IL Israel (IL) Helsinki University Central Hospital (HUCH) / Helsingin seudun yliopistollinen keskussairaala (HYKS) FI Finland (FI)

How to cite

APA:

Nagler, A., Labopin, M., Dholaria, B., Finke, J., Brecht, A., Schanz, U.,... Mohty, M. (2019). Second allogeneic stem cell transplantation in patients with acute lymphoblastic leukaemia: a study on behalf of the Acute Leukaemia Working Party of the European Society for Blood and Marrow Transplantation. British Journal of Haematology. https://doi.org/10.1111/bjh.15973

MLA:

Nagler, Arnon, et al. "Second allogeneic stem cell transplantation in patients with acute lymphoblastic leukaemia: a study on behalf of the Acute Leukaemia Working Party of the European Society for Blood and Marrow Transplantation." British Journal of Haematology (2019).

BibTeX: Download