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
Arnon Nagler
Chaim Sheba Medical Centre, Tel Aviv University, Tel-Hashomer, Israel
EBMT ALWP office, Saint Antoine Hospital, Paris, France
Search for more papers by this authorMyriam Labopin
Department of Haematology and EBMT Paris study office/CEREST-TC, Saint Antoine Hospital, Paris, France
Search for more papers by this authorCorresponding Author
Bhagirathbhai Dholaria
Department of Hematology-Oncology, Vanderbilt University Medical Center, Nashville, TN, USA
Correspondence: Bhagirathbhai Dholaria, Assistant professor, Department of Hematology-Oncology, 2220 Pierce Ave, 686 Preston research building, Vanderbilt University Medical Center, Nashville, TN 37232, USA.
E-mail: [email protected]
Search for more papers by this authorJürgen Finke
Department of Medicine–Haematology Oncology, University of Freiburg, Freiburg, Germany
Search for more papers by this authorArne Brecht
Deutsche Klinik fuer Diagnostik, KMT Zentrum, Wiesbaden, Germany
Search for more papers by this authorUrs Schanz
Clinic of Haematology, University Hospital, Zurich, Switzerland
Search for more papers by this authorRiitta Niittyvuopio
Stem Cell Transplantation Unit, HUCH Comprehensive Cancer Centre, Helsinki, Finland
Search for more papers by this authorAndreas Neubauer
Philipps Universitaet Marburg, University Hospital Giessen and Marburg, Marburg, Germany
Search for more papers by this authorMartin Bornhäuser
Medizinische Klinik und Poliklinik I, Universitaetsklinikum Dresden, Dresden, Germany
Search for more papers by this authorStella Santarone
Dipartimento di Ematologia, Medicina Trasfusionale e Biotecnologie, Ospedale Civile, Pescara, Italy
Search for more papers by this authorDietrich Beelen
Department of Bone Marrow Transplantation, University Hospital, Essen, Germany
Search for more papers by this authorAvichai Shimoni
Department of Bone Marrow Transplantation, Chaim Sheba Medical Centre Chaim Sheba Medical Centre, Tel Hashomer, Israel
Search for more papers by this authorWolf Rösler
Department of Internal Medicine 5, University Hospital Erlangen, Erlangen, Germany
Search for more papers by this authorSebastian Giebel
Department of Bone Marrow Transplantation and Oncohaematology, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Gliwice Branch, Gliwice, Poland
Search for more papers by this authorBipin N. Savani
Department of Hematology-Oncology, Vanderbilt University Medical Center, Nashville, TN, USA
Search for more papers by this authorMohamad Mohty
AService d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Sorobonne University, INSERM UMR 938 and Université Pierre et Marie Curie, Paris, France
Search for more papers by this authorArnon Nagler
Chaim Sheba Medical Centre, Tel Aviv University, Tel-Hashomer, Israel
EBMT ALWP office, Saint Antoine Hospital, Paris, France
Search for more papers by this authorMyriam Labopin
Department of Haematology and EBMT Paris study office/CEREST-TC, Saint Antoine Hospital, Paris, France
Search for more papers by this authorCorresponding Author
Bhagirathbhai Dholaria
Department of Hematology-Oncology, Vanderbilt University Medical Center, Nashville, TN, USA
Correspondence: Bhagirathbhai Dholaria, Assistant professor, Department of Hematology-Oncology, 2220 Pierce Ave, 686 Preston research building, Vanderbilt University Medical Center, Nashville, TN 37232, USA.
E-mail: [email protected]
Search for more papers by this authorJürgen Finke
Department of Medicine–Haematology Oncology, University of Freiburg, Freiburg, Germany
Search for more papers by this authorArne Brecht
Deutsche Klinik fuer Diagnostik, KMT Zentrum, Wiesbaden, Germany
Search for more papers by this authorUrs Schanz
Clinic of Haematology, University Hospital, Zurich, Switzerland
Search for more papers by this authorRiitta Niittyvuopio
Stem Cell Transplantation Unit, HUCH Comprehensive Cancer Centre, Helsinki, Finland
Search for more papers by this authorAndreas Neubauer
Philipps Universitaet Marburg, University Hospital Giessen and Marburg, Marburg, Germany
Search for more papers by this authorMartin Bornhäuser
Medizinische Klinik und Poliklinik I, Universitaetsklinikum Dresden, Dresden, Germany
Search for more papers by this authorStella Santarone
Dipartimento di Ematologia, Medicina Trasfusionale e Biotecnologie, Ospedale Civile, Pescara, Italy
Search for more papers by this authorDietrich Beelen
Department of Bone Marrow Transplantation, University Hospital, Essen, Germany
Search for more papers by this authorAvichai Shimoni
Department of Bone Marrow Transplantation, Chaim Sheba Medical Centre Chaim Sheba Medical Centre, Tel Hashomer, Israel
Search for more papers by this authorWolf Rösler
Department of Internal Medicine 5, University Hospital Erlangen, Erlangen, Germany
Search for more papers by this authorSebastian Giebel
Department of Bone Marrow Transplantation and Oncohaematology, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Gliwice Branch, Gliwice, Poland
Search for more papers by this authorBipin N. Savani
Department of Hematology-Oncology, Vanderbilt University Medical Center, Nashville, TN, USA
Search for more papers by this authorMohamad Mohty
AService d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Sorobonne University, INSERM UMR 938 and Université Pierre et Marie Curie, Paris, France
Search for more papers by this authorSummary
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.
Conflict of interest
Authors report no relevant conflict of interest.
Supporting Information
| Filename | Description |
|---|---|
| bjh15973-sup-0001-Supinfo.pdfPDF document, 305.7 KB |
Table SI. Univariate analysis of factors associated with outcomes of ALL patients who underwent allo-HCT2. Table SII. Outcomes of allo-HCT2 in relapsed acute leukemia patients. Appendix S1. EBMT contributing centers. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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