Transplant Outcomes for Children with T Cell Acute Lymphoblastic Leukemia in Second Remission: A Report from the Center for International Blood and Marrow Transplant Research
Year: 2020
Type: article
Study design: Observational Study
Abstract: Survival for children with relapsed T-ALL is poor when treated with chemotherapy alone and outcomes after allogeneic hematopoietic cell transplantation (HCT) is not well described. Two hundred and twenty-nine children with T-ALL in second complete remission (CR2) received a HCT following myeloablative conditioning between 2000–2011 and were reported to the Center for International Blood and Marrow Transplant Research (CIBMTR). Median age was 10 (range, 2–18) years. Donor source was umbilical cord blood (26%), matched sibling bone marrow (38%) or unrelated bone marrow/peripheral blood (36%). Acute GVHD (grade 2–4) and chronic GVHD occurred in 35% (95% CI, 27–45) and 26% (95% CI, 20–33) of patients. Transplant related mortality at day 100 and 3-year relapse rates were 13% (95% CI, 9–18) and 30% (95% CI, 24–37) respectively. Three year overall survival and disease-free survival were 48% (95% CI, 41–55) and 46% (95% CI, 39–52%) respectively. In multivariate analysis, patients with bone marrow relapse, with or without concurrent extramedullary relapse prior to HCT, were most likely to relapse (HR=3.94, p=0.005) as compared to isolated extramedullary disease. In conclusion, HCT for pediatric T-ALL in CR2 demonstrates reasonable and durable outcomes and consideration for HCT is warranted.
DOI: 10.17615/yyzg-bj38
Authors: Ibrahim, Ahmed, Guilcher, Gregory M.T., Brown, Valerie I., Dvorak, Christopher C., Thiel, Elizabeth, Frangoul, Haydar, Le Rademacher, Jennifer, Kasow, Kimberly A., Shah, Nirali N., Burke, Michael J., Olsson, Richard F., Egeler, R. Maarten, Pulsipher, Michael A., Talano, Julie An, Abraham, Allistair A., He, Wensheng, Ayas, Mouhab, Cairo, Mitchell S., Auletta, Jeffery J., Diaz Perez, Miguel A., Shah, Niketa, Kitko, Carrie L., Hayashi, Robert J., Eldjerou, Lamis, Chan, Ka Wah, Leung, Wing H., Verneris, Michael R., Abdel-Azim, Hisham
Institution: University of North Carolina at Chapel Hill
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funders: U.S. Department of Defense, U.S. Department of Health and Human Services, Amgen, GlaxoSmithKline, Sanofi, WellPoint, Health Research, Teva Pharmaceutical Industries, Ariad Pharmaceuticals, Celgene, HistoGenetics, Osiris Therapeutics, Tarix Pharmaceuticals, Therakos, University of Minnesota, Blue Cross and Blue Shield Association, StemCyte, Medical College of Wisconsin, Otsuka America Pharmaceutical, Sigma-Tau Pharmaceuticals, Actinium Pharmaceuticals, Chimerix, Incyte, Otsuka America, Kiadis Pharma, Swedish Orphan Biovitrum, Medac, Health Resources and Services Administration, Genentech, Onyx Pharmaceuticals, U.S. Navy, Allos Therapeutics, Takeda Oncology, National Heart, Lung, and Blood Institute, Office of Naval Research, National Cancer Institute, National Institute of Allergy and Infectious Diseases
Awards: G1384772222, G1515501300, G1769371581, G205138692, G2108949772, G2220088171, G2814340220, G317906537, G3231857129, G4298420724, G4930744573, G5569911400, DEVELOPMENT OF MEDICAL TECHNOLOGY FOR CONTINGENCY RESPONSE TO MARROW TOXIC SUBSTANCE, G7160503914, G8122066879, G8872364087, G8876996369, A Data Resource for Blood and Marrow Transplants and Adoptive Cellular Therapy Research
OpenAlex ID: W4300937002