Outcome of Second Allogeneic Hematopoietic Cell Transplantation after Relapse of Myeloid Malignancies following Allogeneic Hematopoietic Cell Transplantation
Allogeneic stem cell transplantation (allo-HCT) represents the most effective immunotherapy for acute myeloid leukemia (AML) and myeloid malignancies. However, disease relapse remains the most common cause of treatment failure. By performing a second allo-HCT, durable remission can be achieved in so...
| Autores: | , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Tipo de recurso: | artículo |
| Fecha de publicación: | 2016 |
| País: | España |
| Institución: | Universitat Autònoma de Barcelona |
| Repositorio: | Dipòsit Digital de Documents de la UAB |
| Idioma: | inglés |
| OAI Identifier: | oai:ddd.uab.cat:289667 |
| Acceso en línea: | https://ddd.uab.cat/record/289667 https://dx.doi.org/urn:doi:10.1016/j.bbmt.2015.11.012 |
| Access Level: | acceso abierto |
| Palabra clave: | Acute myeloid leukemia Myeloid malignancies Relapse Second allogeneic stem cell transplantation |
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Outcome of Second Allogeneic Hematopoietic Cell Transplantation after Relapse of Myeloid Malignancies following Allogeneic Hematopoietic Cell TransplantationA Retrospective Cohort on Behalf of the Grupo Español de Trasplante HematopoyeticoOrtí, Guillermo|||0000-0002-7889-5807Sanz, Jaime|||0000-0001-6934-4619Bermúdez, AranchaCaballero, Dolores|||0000-0002-9544-9614Martinez, CarmenMalouf Sierra, Jorge|||0000-0001-5185-520XCabrera Marin, José R.Espigado, Ildefonso|||0000-0002-4043-6613Solano, Carlos|||0000-0003-3702-0817Ferrá, Christelle|||0000-0003-4571-5125García-Noblejas, Ana|||0000-0001-6277-3998Jimenez, SantiagoSampol, Antonia|||0000-0001-7465-6203Yáñez, Lucrecia|||0000-0001-9925-3048García Gutiérrez, Valentín|||0000-0003-4752-0815Pascual, Maria JesusJurado, Manuel|||0000-0001-9156-3797Moraleda, José M.Valcárcel, David|||0000-0002-8747-078XSanz, Miguel A.|||0000-0003-1489-1177Carreras, Enric|||0000-0002-3134-9964Duarte, Rafael F.Acute myeloid leukemiaMyeloid malignanciesRelapseSecond allogeneic stem cell transplantationAllogeneic stem cell transplantation (allo-HCT) represents the most effective immunotherapy for acute myeloid leukemia (AML) and myeloid malignancies. However, disease relapse remains the most common cause of treatment failure. By performing a second allo-HCT, durable remission can be achieved in some patients. However, a second allo-HCT is of no benefit for the majority of patients, so this approach requires further understanding. We present a retrospective cohort of 116 patients diagnosed with AML, myelodysplastic syndromes, and myeloproliferative disorders who consecutively underwent a second allo-HCT for disease relapse. The median age was 38 years (range, 4 to 69 years). Sixty-three patients were alive at last follow-up. The median follow-up of the whole cohort was 193 days (range, 2 to 6724 days) and the median follow-up of survivors was 1628 days (range, 52 to 5518 days). Overall survival (OS) at 5 years was 32% (SE ± 4.7%). Multivariate analysis identified active disease status (P <.001) and second allo-HCT < 430 days (the median of the time to second transplantation) after the first transplantation (P <.001) as factors for poor prognosis, whereas the use of an HLA-identical sibling donor for the second allo-HCT was identified as a good prognostic factor (P <.05) for OS. The use of myeloablative conditioning (P =.01), active disease (P =.02), and a donor other than an HLA-identical sibling (others versus HLA-identical siblings) (P =.009) were factors statistically significant for nonrelapse mortality in multivariate analysis. Time to second transplantation was statistically significant (P =.001) in the relapse multivariate analysis, whereas multivariate analysis identified active disease status (P <.001) and time to second transplantation (P <.001) as poor prognosis factors for disease-free survival. This study confirms active disease and early relapse as dismal prognostic factors for a second allo-HCT. Using a different donor at second allo-HCT did not appear to change outcome, but using an HLA-identical sibling donor for a second transplantation appears to be associated with better survival. Further studies are warranted.Universitat Autònoma de Barcelona 22016-01-0120162016-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/289667https://dx.doi.org/urn:doi:10.1016/j.bbmt.2015.11.012reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.https://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:2896672026-06-06T12:50:31Z |
| dc.title.none.fl_str_mv |
Outcome of Second Allogeneic Hematopoietic Cell Transplantation after Relapse of Myeloid Malignancies following Allogeneic Hematopoietic Cell Transplantation A Retrospective Cohort on Behalf of the Grupo Español de Trasplante Hematopoyetico |
| title |
Outcome of Second Allogeneic Hematopoietic Cell Transplantation after Relapse of Myeloid Malignancies following Allogeneic Hematopoietic Cell Transplantation |
| spellingShingle |
Outcome of Second Allogeneic Hematopoietic Cell Transplantation after Relapse of Myeloid Malignancies following Allogeneic Hematopoietic Cell Transplantation Ortí, Guillermo|||0000-0002-7889-5807 Acute myeloid leukemia Myeloid malignancies Relapse Second allogeneic stem cell transplantation |
| title_short |
Outcome of Second Allogeneic Hematopoietic Cell Transplantation after Relapse of Myeloid Malignancies following Allogeneic Hematopoietic Cell Transplantation |
| title_full |
Outcome of Second Allogeneic Hematopoietic Cell Transplantation after Relapse of Myeloid Malignancies following Allogeneic Hematopoietic Cell Transplantation |
| title_fullStr |
Outcome of Second Allogeneic Hematopoietic Cell Transplantation after Relapse of Myeloid Malignancies following Allogeneic Hematopoietic Cell Transplantation |
| title_full_unstemmed |
Outcome of Second Allogeneic Hematopoietic Cell Transplantation after Relapse of Myeloid Malignancies following Allogeneic Hematopoietic Cell Transplantation |
| title_sort |
Outcome of Second Allogeneic Hematopoietic Cell Transplantation after Relapse of Myeloid Malignancies following Allogeneic Hematopoietic Cell Transplantation |
| dc.creator.none.fl_str_mv |
Ortí, Guillermo|||0000-0002-7889-5807 Sanz, Jaime|||0000-0001-6934-4619 Bermúdez, Arancha Caballero, Dolores|||0000-0002-9544-9614 Martinez, Carmen Malouf Sierra, Jorge|||0000-0001-5185-520X Cabrera Marin, José R. Espigado, Ildefonso|||0000-0002-4043-6613 Solano, Carlos|||0000-0003-3702-0817 Ferrá, Christelle|||0000-0003-4571-5125 García-Noblejas, Ana|||0000-0001-6277-3998 Jimenez, Santiago Sampol, Antonia|||0000-0001-7465-6203 Yáñez, Lucrecia|||0000-0001-9925-3048 García Gutiérrez, Valentín|||0000-0003-4752-0815 Pascual, Maria Jesus Jurado, Manuel|||0000-0001-9156-3797 Moraleda, José M. Valcárcel, David|||0000-0002-8747-078X Sanz, Miguel A.|||0000-0003-1489-1177 Carreras, Enric|||0000-0002-3134-9964 Duarte, Rafael F. |
| author |
Ortí, Guillermo|||0000-0002-7889-5807 |
| author_facet |
Ortí, Guillermo|||0000-0002-7889-5807 Sanz, Jaime|||0000-0001-6934-4619 Bermúdez, Arancha Caballero, Dolores|||0000-0002-9544-9614 Martinez, Carmen Malouf Sierra, Jorge|||0000-0001-5185-520X Cabrera Marin, José R. Espigado, Ildefonso|||0000-0002-4043-6613 Solano, Carlos|||0000-0003-3702-0817 Ferrá, Christelle|||0000-0003-4571-5125 García-Noblejas, Ana|||0000-0001-6277-3998 Jimenez, Santiago Sampol, Antonia|||0000-0001-7465-6203 Yáñez, Lucrecia|||0000-0001-9925-3048 García Gutiérrez, Valentín|||0000-0003-4752-0815 Pascual, Maria Jesus Jurado, Manuel|||0000-0001-9156-3797 Moraleda, José M. Valcárcel, David|||0000-0002-8747-078X Sanz, Miguel A.|||0000-0003-1489-1177 Carreras, Enric|||0000-0002-3134-9964 Duarte, Rafael F. |
| author_role |
author |
| author2 |
Sanz, Jaime|||0000-0001-6934-4619 Bermúdez, Arancha Caballero, Dolores|||0000-0002-9544-9614 Martinez, Carmen Malouf Sierra, Jorge|||0000-0001-5185-520X Cabrera Marin, José R. Espigado, Ildefonso|||0000-0002-4043-6613 Solano, Carlos|||0000-0003-3702-0817 Ferrá, Christelle|||0000-0003-4571-5125 García-Noblejas, Ana|||0000-0001-6277-3998 Jimenez, Santiago Sampol, Antonia|||0000-0001-7465-6203 Yáñez, Lucrecia|||0000-0001-9925-3048 García Gutiérrez, Valentín|||0000-0003-4752-0815 Pascual, Maria Jesus Jurado, Manuel|||0000-0001-9156-3797 Moraleda, José M. Valcárcel, David|||0000-0002-8747-078X Sanz, Miguel A.|||0000-0003-1489-1177 Carreras, Enric|||0000-0002-3134-9964 Duarte, Rafael F. |
| author2_role |
author author author author author author author author author author author author author author author author author author author author author |
| dc.contributor.none.fl_str_mv |
Universitat Autònoma de Barcelona |
| dc.subject.none.fl_str_mv |
Acute myeloid leukemia Myeloid malignancies Relapse Second allogeneic stem cell transplantation |
| topic |
Acute myeloid leukemia Myeloid malignancies Relapse Second allogeneic stem cell transplantation |
| description |
Allogeneic stem cell transplantation (allo-HCT) represents the most effective immunotherapy for acute myeloid leukemia (AML) and myeloid malignancies. However, disease relapse remains the most common cause of treatment failure. By performing a second allo-HCT, durable remission can be achieved in some patients. However, a second allo-HCT is of no benefit for the majority of patients, so this approach requires further understanding. We present a retrospective cohort of 116 patients diagnosed with AML, myelodysplastic syndromes, and myeloproliferative disorders who consecutively underwent a second allo-HCT for disease relapse. The median age was 38 years (range, 4 to 69 years). Sixty-three patients were alive at last follow-up. The median follow-up of the whole cohort was 193 days (range, 2 to 6724 days) and the median follow-up of survivors was 1628 days (range, 52 to 5518 days). Overall survival (OS) at 5 years was 32% (SE ± 4.7%). Multivariate analysis identified active disease status (P <.001) and second allo-HCT < 430 days (the median of the time to second transplantation) after the first transplantation (P <.001) as factors for poor prognosis, whereas the use of an HLA-identical sibling donor for the second allo-HCT was identified as a good prognostic factor (P <.05) for OS. The use of myeloablative conditioning (P =.01), active disease (P =.02), and a donor other than an HLA-identical sibling (others versus HLA-identical siblings) (P =.009) were factors statistically significant for nonrelapse mortality in multivariate analysis. Time to second transplantation was statistically significant (P =.001) in the relapse multivariate analysis, whereas multivariate analysis identified active disease status (P <.001) and time to second transplantation (P <.001) as poor prognosis factors for disease-free survival. This study confirms active disease and early relapse as dismal prognostic factors for a second allo-HCT. Using a different donor at second allo-HCT did not appear to change outcome, but using an HLA-identical sibling donor for a second transplantation appears to be associated with better survival. Further studies are warranted. |
| publishDate |
2016 |
| dc.date.none.fl_str_mv |
2 2016-01-01 2016 2016-01-01 |
| dc.type.none.fl_str_mv |
Article http://purl.org/coar/resource_type/c_6501 VoR http://purl.org/coar/version/c_970fb48d4fbd8a85 |
| dc.type.openaire.fl_str_mv |
info:eu-repo/semantics/article |
| format |
article |
| dc.identifier.none.fl_str_mv |
https://ddd.uab.cat/record/289667 https://dx.doi.org/urn:doi:10.1016/j.bbmt.2015.11.012 |
| url |
https://ddd.uab.cat/record/289667 https://dx.doi.org/urn:doi:10.1016/j.bbmt.2015.11.012 |
| dc.language.none.fl_str_mv |
Inglés eng |
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Inglés |
| language |
eng |
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open access http://purl.org/coar/access_right/c_abf2 https://creativecommons.org/licenses/by-nc-nd/4.0/ |
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info:eu-repo/semantics/openAccess |
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open access http://purl.org/coar/access_right/c_abf2 https://creativecommons.org/licenses/by-nc-nd/4.0/ |
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openAccess |
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application/pdf |
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reponame:Dipòsit Digital de Documents de la UAB instname:Universitat Autònoma de Barcelona |
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