title: Early mixed chimerism-based preemptive immunotherapy in children undergoing allogeneic hematopoietic stem cell transplantation for acute leukemia.
abstract: This retrospective analysis comprises 10-year experience with early posttransplant mixed chimerism-based preemptive intervention. Out of 104 patients, 51 received preemptive immunotherapy. Their outcomes were similar to patients achieving full donor chimerism spontaneously. Among patients receiving intervention, 5-year event-free survival was identical in patients with and without pretransplant residual disease, respectively (68% [95% confidence interval (CI) 38-98%] vs. 69% [95% CI 54-85%] log-rank = 0.4). In patients who received preemptive immunotherapy, chimerism status and residual disease prior to transplant were no longer predictors of poor outcome; however, 41% of the patients with residual disease prior to transplant relapsed early and did not benefit from this strategy.
authors.affiliation: Division of Pediatric Allergy, Immunology and Bone Marrow Transplantation at University of California San Francisco (UCSF) Benioff Children's Hospital, San Francisco, California.
authors.forename: Biljana
authors.initials: B
authors.lastname: Horn
authors.affiliation: Division of Pediatric Allergy, Immunology and Bone Marrow Transplantation at University of California San Francisco (UCSF) Benioff Children's Hospital, San Francisco, California.
authors.forename: Justin T
authors.initials: JT
authors.lastname: Wahlstrom
authors.affiliation: Division of Pediatric Allergy, Immunology and Bone Marrow Transplantation at University of California San Francisco (UCSF) Benioff Children's Hospital, San Francisco, California.
authors.forename: Alexis
authors.initials: A
authors.lastname: Melton
authors.affiliation: Division of Pediatric Allergy, Immunology and Bone Marrow Transplantation at University of California San Francisco (UCSF) Benioff Children's Hospital, San Francisco, California.
authors.forename: Angela
authors.initials: A
authors.lastname: Liou
authors.affiliation: Immuno-Hematology Unit, Robert Debre Hospital, Paris, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Ouachee-Chardin
authors.affiliation: Division of Pediatric Allergy, Immunology and Bone Marrow Transplantation at University of California San Francisco (UCSF) Benioff Children's Hospital, San Francisco, California.
authors.forename: Gauri
authors.initials: G
authors.lastname: Sunkersett
authors.affiliation: Division of Pediatric Allergy, Immunology and Bone Marrow Transplantation at University of California San Francisco (UCSF) Benioff Children's Hospital, San Francisco, California.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Willert
authors.affiliation: UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, California.
authors.forename: Jimmy
authors.initials: J
authors.lastname: Hwang
authors.affiliation: Division of Pediatric Allergy, Immunology and Bone Marrow Transplantation at University of California San Francisco (UCSF) Benioff Children's Hospital, San Francisco, California.
authors.forename: Jueleah
authors.initials: J
authors.lastname: Expose-Spencer
authors.affiliation: Division of Pediatric Allergy, Immunology and Bone Marrow Transplantation at University of California San Francisco (UCSF) Benioff Children's Hospital, San Francisco, California.
authors.forename: Mort C
authors.initials: MC
authors.lastname: Cowan
authors.affiliation: Division of Pediatric Allergy, Immunology and Bone Marrow Transplantation at University of California San Francisco (UCSF) Benioff Children's Hospital, San Francisco, California.
authors.forename: Janelle
authors.initials: J
authors.lastname: Facchino
authors.affiliation: Division of Pediatric Allergy, Immunology and Bone Marrow Transplantation at University of California San Francisco (UCSF) Benioff Children's Hospital, San Francisco, California.
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Dvorak
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D007167:Immunotherapy / Q000379:methods*; D007223:Infant; D053208:Kaplan-Meier Estimate; D015470:Leukemia, Myeloid, Acute / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D012189:Retrospective Studies; D018183:Transplantation Chimera; D023001:Transplantation Tolerance / Q000187:drug effects; D014184:Transplantation, Homologous; D055815:Young Adult
keywords: allogeneic stem cell transplant; immunotherapy; pediatric leukemia