title: Long-term outcome and prognostic factors of second allogeneic hematopoietic stem cell transplant for acute leukemia in patients with a median follow-up of ⩾10 years.
abstract: Second allogeneic hematopoietic stem cell transplantation (HSCT2) is a frequently used treatment option for relapse of acute leukemia after first allogeneic transplantation. Remission can be induced in selected patients, but data on long-term outcome and finally cure are limited. To estimate the long-term results of HSCT2, we retrospectively analyzed the course of 286 patients receiving myeloablative HSCT2 between 1985 and 2000, with a median follow-up of 11.3 years. Overall survival (OS) and leukemia-free survival (LFS) at 10 years from HSCT2 were 10±2 and 7±2%, respectively. Cumulative 10-year incidence of relapse and non-relapse mortality were 58±3% and 35±3%, respectively. CR at HSCT2, an interval from first transplant to relapse >10 months and TBI as part of the conditioning for HSCT2 favorably influenced LFS and OS. Patients with all three favorable factors had a 10-year OS of 36±10% and LFS of 25±9%, whereas patients showing no favorable factor had all died before year 5. Although retrospective, the long follow-up of this analysis supports the curative potential of alloHSCT2 in selected patients, who might be identified in advance, based on prognostic factors.
authors.affiliation: Haematoncology Division, European Institute of Oncology, Milan, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Andreola
authors.affiliation: EBMT Acute Leukemia Working Party office and AP-HP, Service d'Hématologie et Thérapie Cellulaire, Hopital Saint-Antoine, Sorbonne Universités, UPMC Univ Paris 06, and INSERM, UMR_S 938, CDR Saint-Antoine, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Labopin
authors.affiliation: Department of Bone Marrow Transplantation, University Hospital Essen, Essen, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Beelen
authors.affiliation: Hematology Department, Center Hospitalier Universitaire (CHU) de Nantes, Nantes, France.
authors.forename: P
authors.initials: P
authors.lastname: Chevallier
authors.affiliation: Service d'Hematologie Clinique et Therapie Cellulaire, Centre Hospitalier et Universitaire de Bordeaux, Bordeaux, France.
authors.forename: R
authors.initials: R
authors.lastname: Tabrizi
authors.affiliation: Hematology Section, Careggi Hospital and University of Florence, Florence, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Bosi
authors.affiliation: Hematology Department, University Hospital Center, Lyon, France.
authors.forename: M
authors.initials: M
authors.lastname: Michallet
authors.affiliation: Bone Marrow Transplant Center, Department of Hematology, Spirito Santo Hospital, Pescara, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Santarone
authors.affiliation: Department of Medicine I, University Hospital Carl Gustav Carus, Dresden, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Ehninger
authors.affiliation: EBMT Acute Leukemia Working Party office and AP-HP, Service d'Hématologie et Thérapie Cellulaire, Hopital Saint-Antoine, Sorbonne Universités, UPMC Univ Paris 06, and INSERM, UMR_S 938, CDR Saint-Antoine, Paris, France.
authors.forename: E
authors.initials: E
authors.lastname: Polge
authors.affiliation: Haematoncology Division, European Institute of Oncology, Milan, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Laszlo
authors.affiliation: Section for Hematopoietic Stem Cell Transplantation, Klinikum Augsburg, University of Munich, Munich, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Schmid
authors.affiliation: Hematology Division, Tel-Aviv University, Sheba Medical Center, Tel-Hashomer, Israel.
authors.forename: A
authors.initials: A
authors.lastname: Nagler
authors.affiliation: EBMT Acute Leukemia Working Party office and AP-HP, Service d'Hématologie et Thérapie Cellulaire, Hopital Saint-Antoine, Sorbonne Universités, UPMC Univ Paris 06, and INSERM, UMR_S 938, CDR Saint-Antoine, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Mohty
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D064591:Allografts; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007938:Leukemia / Q000401:mortality* / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012042:Registries; D012074:Remission Induction; D012189:Retrospective Studies; D015996:Survival Rate