title: Second allogeneic stem cell transplantation in hematologic malignancies: a single-center experience.
abstract: Patients with hematologic malignancies who relapse after their first hematopoietic stem cell transplantation tend to have poor prognoses. One option for these patients is a second allogeneic hematopoietic stem cell transplantation (allo-HSCT). However, there are few reports of second allo-HSCT therapy in children with relapsed hematologic malignancies. Patient outcomes in 27 individuals with acute leukemia who received at least 2 allo-HSCTs at the Samsung Medical Center between May 1997 and September 2010 were analyzed retrospectively. After a median follow-up of 33 months, 11 of 27 patients (40.7%) were alive and in stable remission. The 5-year overall survival rate for all 27 patients was 32.6%. There was no statistically significant difference in the survival rates of patients differing in their sex, the stem cell source, the donor type, or the presence of acute or chronic graft-versus-host disease. Remission before the second allo-HSCT was the only prognostic factor that influenced the survival rates (44.1% vs. 11.1%, P=0.009). Of 16 cases of mortality, 9 mortality cases (56.3%) were associated with relapse and 7 cases (43.7%) were associated with treatment-related mortality. Therefore, a second allo-HSCT offers the chance of stable remission for some patients with acute hematologic malignancies who relapse after their first allo-HSCT.
authors.affiliation: Department of Pediatrics, Dong-A University Medical Center, Dong-A University College of Medicine, Busan, Republic of Korea.
authors.forename: Hee Won
authors.initials: HW
authors.lastname: Chueh
authors.forename: Soo Hyun
authors.initials: SH
authors.lastname: Lee
authors.forename: Ki Woong
authors.initials: KW
authors.lastname: Sung
authors.forename: Keon Hee
authors.initials: KH
authors.lastname: Yoo
authors.forename: Hong Hoe
authors.initials: HH
authors.lastname: Koo
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D019337:Hematologic Neoplasms / Q000401:mortality* / Q000601:surgery*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods; D006801:Humans; D007223:Infant; D053208:Kaplan-Meier Estimate; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000601:surgery*; D011379:Prognosis; D019172:Transplantation Conditioning / Q000379:methods; D014184:Transplantation, Homologous; D016896:Treatment Outcome