Contributions
Abstract: PB2430
Type: Publication Only
Background
Patients with acute leukemia who relapse after their first allogeneic hematopoietic stem cell transplantation (allo-HSCT1) have poor prognosis. Second allo-HSCT (allo-HSCT2) from matched related or unrelated donor or haplo-identical transplantation has been already used as a potentially curative treatment for patients who relapsed after their first allogeneic stem cell transplantation. There is still limited information about alternative donor sources on the efficacy of allo-HSCT2.
Aims
To identify prognostic factors affecting the outcome of second HSCT, we performed a retrospective study on our patients with acute leukemia.
Methods
Data from Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Stem Cell Transplantation Unit database were retrospectively analyzed.
Results
A total of 319 patients with acute leukemia had received allo-HSCT1 at our center between March 2009 and May 2017. 78 of them relapsed after their first allogeneic stem cell transplantation and 13 of them underwent their second allogeneic stem cell transplantation. The median interval between allo-HSCT1 and allo-HSCT2 was 240 days (range: 120-1800). Patients had acute myeloid leukemia (AML, n = 4), T cell acute lymphoblastic leukemia (T ALL, n = 4), Philedelphia positive B cell acute lymphoblastic leukemia (Ph+ B ALL, n = 3), Philedelphia negative B cell acute lymphoblastic leukemia (Ph neg ALL, n = 2) . All of the patients received myeloablative conditioning regimen. Donors at allo-HSCT2 were HLA-matched or 1 antigen HLA-mismatched related donor (MRD, n = 11) and unrelated donor (URD, n = 2). 7 patients were transplanted from the same donor used in their first transplantation while in 6 patients transplantation was performed from alternative donors.Among 13 patients, 1-year overall survival (OS) and progression-free survival (PFS) rate were 46.1% and 23% respectively. Overall survival rates did not differ between patients with varying age, diagnosis, times of relapse, durations between the first transplantation and the relapse, GVHD grade, donor type(same or different, related or unrelated) and EBMT score.
Conclusion
The outcome of allo-HSCT2 has been still unsatisfactory because of the high rate of TRM and relapse. Outcome of second allogeneic transplantation from an alternative donor is comparable with the second transplantations performed from the same donor.
Session topic: 23. Stem cell transplantation - Clinical
Keyword(s): Second transplant
Abstract: PB2430
Type: Publication Only
Background
Patients with acute leukemia who relapse after their first allogeneic hematopoietic stem cell transplantation (allo-HSCT1) have poor prognosis. Second allo-HSCT (allo-HSCT2) from matched related or unrelated donor or haplo-identical transplantation has been already used as a potentially curative treatment for patients who relapsed after their first allogeneic stem cell transplantation. There is still limited information about alternative donor sources on the efficacy of allo-HSCT2.
Aims
To identify prognostic factors affecting the outcome of second HSCT, we performed a retrospective study on our patients with acute leukemia.
Methods
Data from Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Stem Cell Transplantation Unit database were retrospectively analyzed.
Results
A total of 319 patients with acute leukemia had received allo-HSCT1 at our center between March 2009 and May 2017. 78 of them relapsed after their first allogeneic stem cell transplantation and 13 of them underwent their second allogeneic stem cell transplantation. The median interval between allo-HSCT1 and allo-HSCT2 was 240 days (range: 120-1800). Patients had acute myeloid leukemia (AML, n = 4), T cell acute lymphoblastic leukemia (T ALL, n = 4), Philedelphia positive B cell acute lymphoblastic leukemia (Ph+ B ALL, n = 3), Philedelphia negative B cell acute lymphoblastic leukemia (Ph neg ALL, n = 2) . All of the patients received myeloablative conditioning regimen. Donors at allo-HSCT2 were HLA-matched or 1 antigen HLA-mismatched related donor (MRD, n = 11) and unrelated donor (URD, n = 2). 7 patients were transplanted from the same donor used in their first transplantation while in 6 patients transplantation was performed from alternative donors.Among 13 patients, 1-year overall survival (OS) and progression-free survival (PFS) rate were 46.1% and 23% respectively. Overall survival rates did not differ between patients with varying age, diagnosis, times of relapse, durations between the first transplantation and the relapse, GVHD grade, donor type(same or different, related or unrelated) and EBMT score.
Conclusion
The outcome of allo-HSCT2 has been still unsatisfactory because of the high rate of TRM and relapse. Outcome of second allogeneic transplantation from an alternative donor is comparable with the second transplantations performed from the same donor.
Session topic: 23. Stem cell transplantation - Clinical
Keyword(s): Second transplant