title: Second allogeneic hematopoietic SCT for relapsed ALL in children.
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.
authors.affiliation: Department of Hematology/Oncology, Saitama Children's Medical Center, Saitama, Japan. katom-tky@umin.ac.jp
authors.forename: M
authors.initials: M
authors.lastname: Kato
authors.forename: Y
authors.initials: Y
authors.lastname: Horikoshi
authors.forename: Y
authors.initials: Y
authors.lastname: Okamoto
authors.forename: Y
authors.initials: Y
authors.lastname: Takahashi
authors.forename: D
authors.initials: D
authors.lastname: Hasegawa
authors.forename: K
authors.initials: K
authors.lastname: Koh
authors.forename: J
authors.initials: J
authors.lastname: Takita
authors.forename: M
authors.initials: M
authors.lastname: Inoue
authors.forename: H
authors.initials: H
authors.lastname: Kigasawa
authors.forename: A
authors.initials: A
authors.lastname: Ogawa
authors.forename: Y
authors.initials: Y
authors.lastname: Sasahara
authors.forename: K
authors.initials: K
authors.lastname: Kawa
authors.forename: H
authors.initials: H
authors.lastname: Yabe
authors.forename: H
authors.initials: H
authors.lastname: Sakamaki
authors.forename: R
authors.initials: R
authors.lastname: Suzuki
authors.forename: K
authors.initials: K
authors.lastname: Kato
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000401:mortality* / Q000517:prevention & control*; D012008:Recurrence; D012189:Retrospective Studies; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous