title: Outcome and prognostic factors among patients who underwent a second transplantation for disease relapse post the first allogeneic cell transplantation.
abstract: The prognosis for disease relapse after first hematopoietic cell transplantation (HCT1) is poor. Here, we present a retrospective multicenter study to evaluate the clinical outcome and the prognostic factors for second hematopoietic cell transplantation (HCT2). The cohort in this study comprised 60 patients diagnosed with acute leukemia, who underwent HCT2 due to hematological relapse after HCT1. The overall survival (OS) at two years, non-relapse mortality (NRM), and relapse mortality (RM) were 30.3%, 40.9%, and 28.8%, respectively. Multivariate analysis for OS identified the use of a donor other than matched-related (MR) donor (hazard ratios [HR] = 4.10, 95% confidence intervals [CI]: 1.72-9.74, p = .001) and high disease status (HR = 2.90, 95% CI: 1.28-6.56, p = .011) as the adverse risk factors for HCT2. On analyzing the combination of factors during HCT1 and HCT2, MR donor, reduced intensity conditioning regimen, and standard status were found to be significant as favorable prognostic factors for OS. Therefore, evaluating these prognostic factors would be helpful in taking decisions regarding post-relapse management.
authors.affiliation: a Department of Hematology and Clinical Immunology , Yokohama City University, Graduate School of Medicine , Yokohama , Japan.|b Department of Hematology , Kanagawa Cancer Center , Yokohama , Japan.
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Tachibana
authors.affiliation: c Yokohama City University Medical Center , Yokohama , Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Matsumoto
authors.affiliation: b Department of Hematology , Kanagawa Cancer Center , Yokohama , Japan.
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Tanaka
authors.affiliation: c Yokohama City University Medical Center , Yokohama , Japan.
authors.forename: Maki
authors.initials: M
authors.lastname: Hagihara
authors.affiliation: c Yokohama City University Medical Center , Yokohama , Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Motohashi
authors.affiliation: c Yokohama City University Medical Center , Yokohama , Japan.
authors.forename: Wataru
authors.initials: W
authors.lastname: Yamamoto
authors.affiliation: b Department of Hematology , Kanagawa Cancer Center , Yokohama , Japan.
authors.forename: Eriko
authors.initials: E
authors.lastname: Ogusa
authors.affiliation: a Department of Hematology and Clinical Immunology , Yokohama City University, Graduate School of Medicine , Yokohama , Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Koyama
authors.affiliation: c Yokohama City University Medical Center , Yokohama , Japan.
authors.forename: Ayumi
authors.initials: A
authors.lastname: Numata
authors.affiliation: a Department of Hematology and Clinical Immunology , Yokohama City University, Graduate School of Medicine , Yokohama , Japan.
authors.forename: Naoto
authors.initials: N
authors.lastname: Tomita
authors.affiliation: d Department of Hematology , Shizuoka Red Cross Hospital , Shizuoka , Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Taguchi
authors.affiliation: c Yokohama City University Medical Center , Yokohama , Japan.
authors.forename: Shin
authors.initials: S
authors.lastname: Fujisawa
authors.affiliation: b Department of Hematology , Kanagawa Cancer Center , Yokohama , Japan.
authors.forename: Heiwa
authors.initials: H
authors.lastname: Kanamori
authors.affiliation: a Department of Hematology and Clinical Immunology , Yokohama City University, Graduate School of Medicine , Yokohama , Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Nakajima
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology / Q000517:prevention & control; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods; D006801:Humans; D007938:Leukemia / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D019233:Retreatment; D012189:Retrospective Studies; D016019:Survival Analysis; D014019:Tissue Donors; D019172:Transplantation Conditioning / Q000009:adverse effects / Q000379:methods; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult
keywords: Second donor; acute leukemia; hematologic relapse