Allogeneic hematopoietic cell transplantation outcomes for children with B-precursor acute lymphoblastic leukemia and early or late BM relapse

J. C. Beck, Q. Cao, B. Trotz, A. R. Smith, B. J. Weigel, M. R. Verneris, M. J. Burke

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Large registry studies have shown superior disease-free survival (DFS) with matched sibling donor (MSD) allogeneic hematopoietic cell transplantation (allo-HCT) over chemotherapy alone for patients with B-precursor acute lymphoblastic leukemia (ALL) and a late BM relapse. As most of these patients will not have an MSD, the decision to pursue an unrelated allo-HCT in second remission (CR2) or await a future relapse and perform HCT in third remission (CR3) continues to be debated. Between 1990 and 2006, 41 children with relapsed B-precursor ALL received a myeloablative allo-HCT at the University of Minnesota. Graft sources consisted of matched related donor (n=11), matched unrelated donor (n9), and unrelated umbilical cord blood (n=21). Before allo-HCT, 15 patients had an early relapse (>36 months from diagnosis) and 26 had an initial late relapse (≥36 months from diagnosis). In all, 30 patients (73%) were in CR2 and 11 were in CR3 (27%) at time of allo-HCT. Five year OS/DFS were similar for patients with an early or late marrow relapse, but there was inferior DFS among late-relapse patients transplanted in CR3 compared with CR2 (30% vs 75%, P0.04). These results suggest that allo-HCT should be pursued in children after a first marrow relapse, rather than waiting for subsequent recurrence.

Original languageEnglish (US)
Pages (from-to)950-955
Number of pages6
JournalBone marrow transplantation
Volume46
Issue number7
DOIs
StatePublished - Jul 1 2011

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Cell Transplantation
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Recurrence
Disease-Free Survival
Tissue Donors
Siblings
Bone Marrow
Unrelated Donors
Fetal Blood
Registries
Transplants
Drug Therapy

Keywords

  • ALL
  • allogeneic hematopoietic cell transplantation
  • relapse

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Allogeneic hematopoietic cell transplantation outcomes for children with B-precursor acute lymphoblastic leukemia and early or late BM relapse. / Beck, J. C.; Cao, Q.; Trotz, B.; Smith, A. R.; Weigel, B. J.; Verneris, M. R.; Burke, M. J.

In: Bone marrow transplantation, Vol. 46, No. 7, 01.07.2011, p. 950-955.

Research output: Contribution to journalArticle

Beck, J. C. ; Cao, Q. ; Trotz, B. ; Smith, A. R. ; Weigel, B. J. ; Verneris, M. R. ; Burke, M. J. / Allogeneic hematopoietic cell transplantation outcomes for children with B-precursor acute lymphoblastic leukemia and early or late BM relapse. In: Bone marrow transplantation. 2011 ; Vol. 46, No. 7. pp. 950-955.
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