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Allografting

Outcomes of second allogeneic hematopoietic stem cell transplantation for patients with acute lymphoblastic leukemia

Bone Marrow Transplantation volume 48, pages 666–670 (2013)Cite this article

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Abstract

For patients with ALL who relapse following allo-SCT, only a second SCT provides a realistic chance for long-term disease remission. We retrospectively analyzed the outcomes of 31 patients with relapsed ALL after a prior allo-SCT, who received a second SCT (SCT2) at our center. With a median follow-up of 3 years, 1- and 3-year PFS was 23 and 11% and 1- and 3 year OS rates were 23 and 11%. Twelve patients (39%) were transplanted with active disease, of whom 75% attained a CR. We found a significant relationship between the time to treatment failure following first allograft (SCT1) and PFS following SCT2 (P=0.02, hazard ratio=0.93/month). In summary, a second transplant remains a potential treatment option for achieving response in a highly refractory patient population. While long-term survival is limited, a significant proportion of patients remains disease-free for up to 1 year following SCT2, providing a window of time to administer preventive interventions. Notably, our four long-term survivors received novel therapies with their second transplant underscoring the need for a fundamental change in the methods for SCT2 to improve outcome.

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Authors and Affiliations

  1. Department of Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, TX, USA

    L M Poon, G Rondon, A Hamdi, M Qazilbash, C Hosing, R B Jones, E J Shpall, U R Popat, Y Nieto, M De Lima, R E Champlin & P Kebriaei

  2. Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, TX, USA

    R Bassett Jr

  3. Department of Pediatrics, University of Texas MD Anderson Cancer Center, Houston, TX, USA

    L L Worth & L Cooper

Authors
  1. L M Poon
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  2. R Bassett Jr
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  3. G Rondon
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  4. A Hamdi
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  5. M Qazilbash
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  6. C Hosing
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  7. R B Jones
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  8. E J Shpall
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  9. U R Popat
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  10. Y Nieto
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  11. L L Worth
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  12. L Cooper
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  13. M De Lima
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  14. R E Champlin
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  15. P Kebriaei
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Correspondence to P Kebriaei.

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Poon, L., Bassett Jr, R., Rondon, G. et al. Outcomes of second allogeneic hematopoietic stem cell transplantation for patients with acute lymphoblastic leukemia. Bone Marrow Transplant 48, 666–670 (2013). https://doi.org/10.1038/bmt.2012.195

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  • DOI: https://doi.org/10.1038/bmt.2012.195

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