Outcome of Second Allogeneic Hematopoietic Cell Transplantation in Patients With Acute Lymphoblastic Leukemia

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Abstract

Background:

The outcome of patients with acute lymphoblastic leukemia (ALL) relapsing after allogeneic hematopoietic cell transplantation (AlloHCT) is poor. Although morphologic remission can sometimes be achieved, such remissions are usually transient if not consolidated by a second AlloHCT (AlloHCT2).

Materials and Methods:

We retrospectively analyzed the outcomes of 27 patients with ALL who had undergone AlloHCT2 for relapsed disease at our center during a 12-year period.

Results:

With a median follow-up of 50.9 months for living patients, the 2-year overall and event-free survival were 40.7% and 29.6%, respectively. Patients with either a disease-free interval or interval between transplants of > 1 year had better overall survival (P = .02 and P = .0005) after AlloHCT2.

Conclusion:

AlloHCT2 remains a potential curative option in a subset of patients with relapsed ALL after the first AlloHCT.

Micro-Abstract:

The outcome of patients with acute lymphoblastic leukemia relapsing after first allogeneic hematopoietic cell transplantation remains poor. A second transplant is a potential curative option for a subset of patients. Patients with relapse within the first year after allogeneic hematopoietic cell transplantation should preferably be enrolled in a clinical trial of novel therapies.

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