title: Second reduced intensity conditioning allogeneic transplant as a rescue strategy for acute leukaemia patients who relapse after an initial RIC allogeneic transplantation: analysis of risk factors and treatment outcomes.
abstract: Limited therapeutic options are available after relapse of acute leukaemia following first reduced intensity conditioning haematopoietic stem cell transplantation (RIC1). A retrospective study on European Society for Blood and Marrow Transplantation (EBMT) registry data was performed on 234 adult patients with acute leukaemia who received a second RIC transplantation (RIC2) from 2000 to 2012 as a salvage treatment for relapse following RIC1. At the time of RIC2, 167 patients (71.4%) had relapsed or refractory disease, 49 (20.9%) were in second CR and 18 (7.7%) in third or higher CR. With a median follow-up of 21 (1.5-79) months after RIC2, 51 patients are still alive. At 2 years, the cumulative incidence of non-relapse mortality (NRM), relapse incidence (RI), leukaemia-free survival (LFS) and overall survival (OS) were 22.4% (95% confidence interval (CI): 17-28.4), 63.9% (56.7-70.1), 14.6% (8.8-18.5) and 20.5% (14.9-26.1), respectively. In patients with acute myelogenous, biphenotypic and undifferentiated leukaemia (representing 89.8% of all patients), duration of remission following RIC1 >225 days, presence of CR at RIC2, patient's Karnofsky performance status >80 at RIC2 and non-myeloablative conditioning were found to be the strongest predictors of patients' favourable outcome.
authors.affiliation: Department of Hematology, University Hospital Centre Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia.
authors.forename: R
authors.initials: R
authors.lastname: Vrhovac
authors.affiliation: AP-HP, Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, Paris, France.|Sorbonne Universités, UPMC Univ Paris 06, UMR_S 938, CDR Saint-Antoine, Paris, France.|INSERM, UMR_S 938, CDR Saint-Antoine, Paris, France.|EBMT ALWP Office, Hospital Saint Antoine, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Labopin
authors.affiliation: Hematology and Bone Marrow Transplantation, San Raffaele Scientific Institute, Milano, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Ciceri
authors.affiliation: Medicine, Hematology and Oncology, University of Freiburg, Freiburg, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Finke
authors.affiliation: Hematology and Oncology, University of Regensburg, Regensburg, Germany.
authors.forename: E
authors.initials: E
authors.lastname: Holler
authors.affiliation: Ludwig-Maximilians University Hospital of Munich-Grosshadern, Department of Internal Medicine III, Hematopoietic cell Transplantation, Munich, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Tischer
authors.affiliation: Hematology, Oncology and Bone Marrow Transplantation, CHU Hautepierre, Strasbourg, France.
authors.forename: B
authors.initials: B
authors.lastname: Lioure
authors.affiliation: St Bartholomew's and The Royal London NHS Trust, London, UK.
authors.forename: J
authors.initials: J
authors.lastname: Gribben
authors.affiliation: Department of Medicine, Tübingen University, Tübingen, Germany.
authors.forename: L
authors.initials: L
authors.lastname: Kanz
authors.affiliation: Transplantation and Cellular Therapy, Institut Paoli Calmettes, Marseille, France.
authors.forename: D
authors.initials: D
authors.lastname: Blaise
authors.affiliation: Department of Medicine V, University of Heidelberg, Heidelberg, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Dreger
authors.affiliation: Internal Medicine, BMT Unit, University of Saarland, Homburg, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Held
authors.affiliation: Hematology and Oncology, Charite, Universitaetsmedizin, Berlin, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Arnold
authors.affiliation: EBMT ALWP Office, Hospital Saint Antoine, Paris, France.|Chaim Sheba Medical Center, Tel-Hashomer, Israel.
authors.forename: A
authors.initials: A
authors.lastname: Nagler
authors.affiliation: AP-HP, Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, Paris, France.|Sorbonne Universités, UPMC Univ Paris 06, UMR_S 938, CDR Saint-Antoine, Paris, France.|INSERM, UMR_S 938, CDR Saint-Antoine, Paris, France.|EBMT ALWP Office, Hospital Saint Antoine, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Mohty
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; 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; D012307:Risk Factors; D015996:Survival Rate; D019172:Transplantation Conditioning / Q000379:methods*