Role of a second transplantation for children with acute leukemia following posttransplantation relapse: a study by the Turkish Bone Marrow Transplantation Study Group

Abstract

We examined outcomes of 51 pediatric patients with relapsed acute leukemia (AL) who underwent a second allogeneic hematopoietic stem cell transplantation (alloHSCT). After a median follow-up of 941 days (range, 69–2842 days), leukemia-free survival (LFS) and overall survival (OS) at 3 years were 26.6% and 25.6%, respectively. The nonrelapse mortality rate (NMR) and cumulative incidence of relapse (CIR) were 36.4% and 42.4%, respectively. The Cox regression analysis demonstrated that the risk factors at second transplantation for predicting limited LFS were active disease (hazard ratio (HR) = 5.1), reduced intensity conditioning (RIC) (HR = 5.0), matched unrelated donor (MUD) (HR = 3.4) and performance score <80 (HR = 3.2). Pediatric patients with AL who relapsed after their first alloHSCT may survive with a second alloHSCT. Disease status, conditioning intensity, donor type, and performance score at the second transplantation are the relevant risk factors. A score based on these factors may predict the results of the second transplantation.

Keywords:

• Posttransplantation relapse
• second transplantation
• acute leukemia
• children

Acknowledgements

We acknowledge the support of American Journal Experts for English editing.

Author contributions

VH designed the study, collected and analyzed data, and wrote the paper; VU provided patient care and created the figures; GTK, NÖ, MK, GÖ, HD, SÇK, TA, EÜ, ÜK, AY, AA, OG, AK, FVO, Tİ, SK, İB, BŞK, MG, ZK, İOB, TP and SA provided patient care and contributed to the manuscript.

Disclosure statement

The authors declare no conflict of interest.