- For children with acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), or myelodysplastic syndrome (MDS) who have relapsed after an allogeneic hematopoietic stem cell transplant (HSCT), a second transplant may serve as successful salvage therapy.
Why this matters
- Disease relapse is the most common cause of mortality after HSCT, and 20%-30% of children who receive allogeneic HSCT are likely to experience a relapse.
- The study included children with ALL, AML, or MDS who experienced disease relapse following their first HSCT (n=221).
- Funding: St. Jude’s Children’s Research Hospital; American Society of Hematology; American Society for Transplantation and Cellular Therapy.
- Of the patients with relapse, 60% received some chemotherapy or supportive care, 13% received donor lymphocyte infusion alone, and 28% received a second HSCT.
- The 3-year OS for patients who received a second HSCT was significantly higher than for those who did not (28% vs 4%).
- In a multivariable analysis, factors associated with better OS included:
- Longer interval from first HSCT to relapse (P<.001>
- Eligible to receive a second HSCT (P<.001 and>
- Receiving HSCT in the current decade (P<.001>
- Retrospective design.