The second therapeutic trial for children with hematological malignancies who relapsed after their first allogeneic SCT: long-term outcomes.
The impact of a second all-SCT on the long-term outcomes of children who relapse after allo-SCT has been unclear. We retrospectively analyzed the long-term outcomes of different salvage treatments for such children. Sixty-six children with hematological malignancies (40 ALL, 22 AML, three MDS, and one CML) who relapsed after a first allo-SCT received either a second allo-SCT (n = 16) or CTx and/or DLI (n = 50). The median follow-up for all children was 9.1 yr. The five-yr OS after relapse was significantly better in patients who underwent a second allo-SCT (42.9%) than in patients treated with CTx and/or DLI (11.8%) (p < 0.05). However, this advantage diminished with increasing time. The eight-yr OS for these groups of patients were 21.4% and 11.8%, respectively (p = n.s.). Among the 16 patients who received a second allo-SCT, two died more than five yr after the second allo-SCT. A second allo-SCT can therefore lead to a prolonged OS in patients who relapse after allo-SCT. However, a second allo-SCT should be selected carefully. This is because the mortality rate is still high, even when there is an extensive duration of time following the second allo-SCT.
Section of Pediatrics, National Kyushu Cancer Center, Fukuoka, Japan. adu44150@ams.odn.ne.jp
Takuro
T
Nishikawa
Jiro
J
Inagaki
Yoshihisa
Y
Nagatoshi
Reiji
R
Fukano
Kentaro
K
Nakashima
Nobuhiro
N
Ito
Daisuke
D
Sawa
Yoshifumi
Y
Kawano
Jun
J
Okamura
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D019337:Hematologic Neoplasms / Q000628:therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012008:Recurrence; D012189:Retrospective Studies; D033581:Stem Cell Transplantation / Q000379:methods*; D013997:Time Factors; D014184:Transplantation, Homologous / Q000379:methods*; D016896:Treatment Outcome