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Acute Leukaemia

The dismal outcome in patients with acute leukaemia who relapse after an autograft is improved if a second autograft or a matched allograft is performed

Bone Marrow Transplantation volume 25, pages 1053–1058 (2000)Cite this article

Abstract

All patients receiving autografts for acute leukaemia in remission between 1 January 1981 and 31 December 1996 and reported to the European Group for Blood and Marrow Transplantation and had a relapse, were included. The patients underwent an allograft (n = 90, group A), were treated with chemotherapy (n = 2584, group B) or received a second autograft (n = 74, group C). The 2-year survival after relapse was 32 ± 5%, 11 ± 1% and 42 ± 6% in groups A, B and C, respectively. In group A, those with an HLA-A, -B and -DR compatible related or unrelated donor had a 2-year survival of 37 ± 7% compared to 13 ± 8% for those receiving a graft from an HLA mismatched donor (n = 20). the following factors were associated with better survival in multivariate analyses: an interval from first autograft to relapse >5 months (P < 0.00001), a first autograft performed later than 1991 (P < 0.00001), patient age below 26 years (median, P < 0.002), group b vs HLA mismatches from group A (P = 0.002), group C vs group B (P < 0.005), patients who were not treated with total body irradiation at first autograft (P < 0.02) and patients in first remission at first autograft (P = 0.02). To conclude, the poor outcome in these patients was improved if a second autograft was feasible (P < 0.005), or if an hla-matched allograft was performed (ns). Bone Marrow Transplantation (2000) 25, 1053–1058.

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Acknowledgements

This work was supported by EBMT Funds, convention 6113, from the Association por la Recherche, Contre la Cancer (ARC), Villejuif, France, and grant from Etablissement Francaise des Graftes (EFG). O Ringdén was supported by grants from the Swedish Cancer Foundation (0070-B95-09XCC), the Children's Cancer Foundation (1995/035), the Swedish Medical Research Council (B96-16X-05971-16C), the FRF Foundation, the Tobias Foundation and the Ellen Bachrach foundation. We thank Inger Hammarberg for excellent typing of this manuscript and Zoe and Francis Walsh for scrutinizing the language.

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Authors and Affiliations

  1. Centre for Allogeneic Stem Cell Transplantation, Huddinge Hospital, Sweden

    O Ringdén

  2. Department of Clinical Immunology, Huddinge Hospital, Sweden

    O Ringdén

  3. Centre Claude Bernard, Centre International Greffes de Moelle, Hôpital Saint-Antoine and EBMT Data Center, Institut des Cordeliers, Paris, France

    M Labopin, NC Gorin & L Fouillard

  4. Dipartimento Di Biotechnologia Cellulare et Hematologia, Univ. degli Studi la Sapienza, Rome, Italy

    G Meloni

  5. Inst. Paoli I Calmettes, Marseille, France

    D Blaise

  6. Université Victor Segalen Bordeaux 2, Bordeaux, France

    J Reiffers

  7. Department of Internal Medicine, University Hospital, Uppsala, Sweden

    K Carlson

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  2. M Labopin
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  3. NC Gorin
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  4. G Meloni
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Consortia

F Frassoni for the Acute Leukaemia Working Party of the European Group for Blood and Marrow Transplantation (EBMT)

Appendix: contributors

Appendix: contributors

We are indebted to all the following EBMT Teams, which submitted patient data and made this study possible: Univ. Degli Studi La Sapienza, Roma; Inst. Paoli I Calmettes, Marseille; Hôpital Saint Antoine, Paris; Hôpital du Haut Leveque, Pessac; University Hospital, Uppsala; Medizinische Klinik u. Poliklinik V, Heidelberg; University College, London; Hospital Universitario La Fe, Valencia; Hospital Clinic, Barcelona; Ospedale, Bergamo; University Hospital, Essen; Hospital M Infantil Vall d′Hebron, Barcelona; Hôpital Jean Minjoz, Busançon; Hospital Universitario La Fe, Santander; Royal Free Hospital, London; Cattedra di Ematologia, University, Parma; University Hospital, Utrecht; Cliniques Universitaires St Luc, Brussels; Hospital Santa Creu i Saint Pau, Barcelona; Glasgow Royal Infirmary, Glasgow; Hôpital Bretonneau, Tours; Universitat, Leipzig; Inst. Scienze Medicho, Milano; University Hospital, Leiden; Ospedale San Martino, Genova; Royal Victoria Infirmary, Newcastle; King Faisal Specialist Hospital, Riyadh; Hôpital de Purpan, Toulouse; University Hospital, Huddinge; Hospital San Maurizio, Bolzano; Hospital Universitario ′Virgen del Rocio′, Sevilla; Hospital Casa Sollievo Della Softerenza, Giovanni Rotondo; Hospital San Orsola, Bologna; University Hospital Centre-Rebro, Zagreb; Hôtel Dieu, Paris; Hôpital Henri Mondor, Créteil; University Hospital, Torino; Hôpital d′Enfants de la Timone, Marseille; Ospedale di Careggi, Firenze; University Hospital St Radboud, Nijmegen; S Camillo Hospital, Rome; Hôtel Dieu, Nantes; Istituto di Radioterapia, Padova; Policlinico San Malteo, Pavia; Hôpital E Herriot, Lyon; Silesian Medical Academy, Katowice; University Hospital Gasthuisberg, Leuven; Heartlands Hospital, Birmingham; IRCCS Policlinico San Matteo, Pavia; The George Papanicolaou, Exokhi; Hôpital Trosseau, Paris; East Hospital, Göteborg; Universität, Frankfurt; Universita Cattolica S Cuore, Roma; Policlinico Borgo Roma Ematologia, Verona; Dr Daniel den Hoed Cancer Center, Rotterdam; Hôpital de Brabois, Nancy; Ospedale V Cervello, Palermo; Addenbrookes Hospital, Cambridge; Hôpital Debrousse, Lyon; University Hospital, Lund; Istituto per l′Infanzie Burio Garololo, Trieste; Centre Hospitallier Universitaire, Clermont-Ferrand; Pesaro Hospital, Pesaro; University Hospital, Maastricht; ULSSN8 ′Vicenza′ Presidio Ospeda-liero, Vicenza; Kantonspital, Basel; Academisch Ziekenhuis, Amsterdam; Medical School, Hannover; Hospital Covadonga, Oviedo; Hôpital C Nicolic; Rouen; Hôpital St Louis, Paris; Royal University Hospital, Liverpool; Hospital Las Palmas; Karolinska Hospital, Stockholm; CHU, Dijon; Universität, Ulm; Hôpital A Michallon, Grenoble; Hôpital Cimiez, Nice; University, Regensburg; Westminster Hospital, London; Cordoba Hospital; Ospedale Civile, Pescara; Institute G Gaslini, Genova; Spedali Civili, Brescia; Hôpital Sud, Rennes; Hôpital Beaujon, Clichy; University, Liege; Ospedale Oncologico, Cagliari; CHU Lapeyronie, Montpellier; Hôpital la Pitié-Salpétrière, Paris; The London Clinic; Ospedale Regina Margherita, Torino; Hospital Tianjin; Sharlati Hospital, Teheran; Hospital Infantil La Fe, Valencia; Hôpital du Val de Grace, Paris; Institut Gustave Roussy, Villejuif; The Ned Children′s Hospital, Sydney; Hospital Infantil La Paz, Madrid; University of Jena; ′Federico II′ Medical School, Napoli; UCT Medical School, Cape Town; Inst. Portugues Oncologia, Lisboa; University Hospital, Tübingen; Hôpital Paul Brousse, Villejuif; Hôpital Haute-pierre, Strasbourg; Clinica Puerta de Hierro, Madrid; Ospedale di Torrette, Ancona; Royal Marsden Hospital, Surrey; University Hospital, Bern; Royal Infirmary, Edinburgh; Hôpital Cantonal Universitaire, Geneva; Hôpital Cochin, Paris; Ospedale di Niguarda; Milano; Klinikum Grosshadern, München; Antararlida Hospital Pivedo; Buenos Aires; Hôpital Nord, Saint Etienne; Hôpital la Milétrie, Poitiers; Hôpital Claude Huriez, Lille; University Hospital Birmingham NHS Trust; AZ Sint-Jan, Bruggo; Royal Manchester Children′s Hospital, Pandlebury; St Anna Kinderspital, Vienna; Universitätskrankenhaus Eppendorg, Hamburg; CHRU, Angers; CH Intercommunal, Creteil; University Hospital, Udine; Hospital General Universitario, Murcie; Medical Center Hospital, Örebro; University Hospital, Linköping; Istituto di Clinico Pediatrica, Pisa; University Hospital, Helsinki; Centro Trapianti di Midollo Osseo, Cremona; Rikshospitalet, Oslo; University Hospital, Beijing; Herlev Hospital; ULB Hôpital Erasme, Brussels; Institute of Hematology, Praha; CHU A Morvan, Brest; Hospital Reggio Celebri; Hospital Clinico, Salamanca; The Center for Pediatric Hematology Oncology, Petach-Tikva; Institut Catal`a d′Oncologia, Barcelona: King′s College School of Medicine, London; University of Erlangen-Nüremberg, Erlangen; BMT Unit, University, Vienna; University Hospital, Innsbruck; Centre Jean Perrin; Clermond-Ferrand; Hospital Clinico Universitario, Valencia; Inst. Portugues Oncologia BMT Unit, Porto; The Queen Elizabeth Hospital, Woodville; Hospital Nuestra Senora Aranzazu, San Sebastian; University Hospital, Bratislava; Ibni Sina Hospital, Ankara; Århus Amtssygehus, Århus; Charles University Hospital, Pilsen; Universita Tor Verguata, Rome; AZ Middelheim, Antwerp; Ematologia ′Giovanni di Gugliefmo′, Avellino; University of Perugia; Hospital No. 9, Minsk; Hôpital Robert Debré, Paris; CHU Robert Debré, Reims; Hammersmith Hospital, London; Royal South Hants Hospital, Southampton; General Hospital, Lanzhou; Royal Devon and Exeter Hospital, Exeter; Hospital Regional, Malaga; Evangelismos Hospital, Athens; Klinikum Nürnberg, University Hospital VUB, Brussels; University Hospital, Tampere; Hôpital de Brabois, Nancy; Royal Hospital, Perth; Royal Infirmary, Leicester; Hospital Son Durata, Palma de Mallorca; Clinica Corachan, Barcelona; University, Palermo; Hôpital Avicienne, Bobigny; Hôpital Necker, Paris; Great Ormond Street Hospital, London; The Oxford Radcliffe Hospital; St James Hospital Trinity College, Dublin; Humboldt Universität, Berlin; HCI International Medical Centre, Clydebank; Bristol Hospital for Sick Children; BMT Unit, Druski Hospital, Wroclaw; Centre René Huguentin, St Cloud; Military Medical Academy, Belgrade; RG Voll Hebron, Barcelona; University Med. Center, Ljubljana; Russian Institute of Hematology, St Petersburg; K Marcinkowski University of Medical Science, Poznan; YSBYTY, Gwynedd; Clinica Universitaria de Navarra, Pamplona; University Hospital, Gent; ′Aghia Sophia′ Children′s Hospital, Athens; Tel-Aviv University, Tel-Hashomer; Our Lady′s Hospital for Sick Children, Dublin; University of Saarland, Homburg-Saar; University of Catania, Catania; Hospital, Harrow; Derriford Hospital, Plymouth; University, München; Val de Grace, Paris; Hôpital E Miller, Mulhouse; CAC F Daciesse, Caen; Hôpital de Hautepierre, Strasbourg; Hôpital Beaujon, Clichy; CHU, Amiens; Hôpital Pasteur, Colmar.

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Ringdén, O., Labopin, M., Gorin, N. et al. The dismal outcome in patients with acute leukaemia who relapse after an autograft is improved if a second autograft or a matched allograft is performed. Bone Marrow Transplant 25, 1053–1058 (2000). https://doi.org/10.1038/sj.bmt.1702409

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