This multi-center study of 373 children who relapsed after allogeneic hematopoietic cell transplantation (HCT) revealed several prognostic factors predicting overall survival and leukemia-free survival in a subset of these patients.
Children in this study underwent a second HCT at 120 centers between 2004 and 2013 to treat their relapsed acute myeloid leukemia (AML; n=159) or acute lymphoblastic leukemia (ALL; n=214).
For all patients, 2- and 5-year overall survival (OS) was 38% and 29%, respectively. Two- and 5-year leukemia-free survival (LFS) was 30% and 25%, respectively.
Favorable prognostic factors for OS and LFS included >12 months between transplants and chronic graft-versus-host disease (GVHD) after the first HCT (both groups), and complete response before the second HCT (ALL only) (p<0.05 for all comparisons).
The researchers concluded that “children with relapsed acute leukemias have a substantial chance at long-term survival following second HCT.” The results “are particularly relevant in the current era which has seen an explosion of new therapies, specifically targeted therapies and immune modulators that may ultimately serve as a bridge to transplantation or an alternative to it.”