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Pediatric Transplants

Second allogeneic hematopoietic SCT for relapsed ALL in children

Bone Marrow Transplantation volume 47, pages 1307–1311 (2012)Cite this article

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Abstract

A second SCT is generally accepted as the only potentially curative approach for ALL patients that relapse after SCT, but the role of second SCT for pediatric ALL is not fully understood. We performed a retrospective analysis of 171 pediatric patients who received a second allo-SCT for relapsed ALL after allo-SCT. OS at 2 years was 29.4±3.7%, the cumulative incidence of relapse was 44.1±4.0% and non-relapse mortality was 18.8±3.5%. Relapse occurred faster after the second SCT than after the first SCT (117 days vs 164 days, P=0.04). Younger age (9 years or less), late relapse (180 days or more after first SCT), CR at the second SCT, and myeloablative conditioning were found to be related to longer survival. Neither acute GVHD nor the type of donor influenced the outcome of second SCT. Multivariate analysis showed that younger age and late relapse were associated with better outcomes. Our analysis suggests that second SCT for relapsed pediatric ALL is an appropriate treatment option for patients that have achieved CR, which is associated with late relapse after the first SCT.

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Acknowledgements

We thank all the clinicians and hospital and health center administrators who provided precise data via the registry of the Japan Society for Stem Cell Transplantation (JSHCT).

Author contributions: MK, YH, YO, YT, DH and KK designed the research; K Koh, JT, MI, HK, AO, YS, K Kawa, HY, HS and RS collected the data; and MK analyzed the data and wrote the paper. All authors discussed the results and commented on the paper.

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Authors and Affiliations

  1. Department of Hematology/Oncology, Saitama Children's Medical Center, Saitama, Japan

    M Kato & K Koh

  2. Department of Hematology/Oncology, Shizuoka Children's Hospital, Shizuoka, Japan

    Y Horikoshi

  3. Department of Pediatrics, Kagoshima University, Kagoshima, Japan

    Y Okamoto

  4. Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Y Takahashi

  5. Department of Hematology Oncology, Hyogo Children's Hospital, Hyogo, Japan

    D Hasegawa

  6. Department of Cell Therapy and Transplantation Medicine, University of Tokyo, Tokyo, Japan

    J Takita

  7. Department of Hematology/Oncology, Osaka Medical Center and Research Institute for Maternal of Child Health, Osaka, Japan

    M Inoue & K Kawa

  8. Department of Hematology, Kanagawa Children's Medical Center, Kanagawa, Japan

    H Kigasawa

  9. Department of Pediatrics, Niigata Cancer Center Hospital, Niigata, Japan

    A Ogawa

  10. Department of Pediatrics, Tohoku University, Tohoku, Japan

    Y Sasahara

  11. Department of Cell Transplantation and Regenerative Medicine, Tokai University, Tokai, Japan

    H Yabe

  12. Department of Hematology, Tokyo Metropolitan Cancer and Infectious Disease Center, Komagome Hospital, Komagome, Japan

    H Sakamaki

  13. Department Of HSCT Data Management And Biostatistics, Nagoya University, Nagoya, Japan

    R Suzuki

  14. Division of Hematology/Oncology,

    K Kato

  15. , Children's Medical Center, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan

    K Kato

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  1. M Kato
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  2. Y Horikoshi
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  7. J Takita
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  15. R Suzuki
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Correspondence to M Kato.

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Kato, M., Horikoshi, Y., Okamoto, Y. et al. Second allogeneic hematopoietic SCT for relapsed ALL in children. Bone Marrow Transplant 47, 1307–1311 (2012). https://doi.org/10.1038/bmt.2012.29

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  • DOI: https://doi.org/10.1038/bmt.2012.29

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