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Acute Leukemia

Long-term outcome and prognostic factors of second allogeneic hematopoietic stem cell transplant for acute leukemia in patients with a median follow-up of ⩾10 years

Bone Marrow Transplantation volume 50, pages 1508–1512 (2015)Cite this article

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Abstract

Second allogeneic hematopoietic stem cell transplantation (HSCT2) is a frequently used treatment option for relapse of acute leukemia after first allogeneic transplantation. Remission can be induced in selected patients, but data on long-term outcome and finally cure are limited. To estimate the long-term results of HSCT2, we retrospectively analyzed the course of 286 patients receiving myeloablative HSCT2 between 1985 and 2000, with a median follow-up of 11.3 years. Overall survival (OS) and leukemia-free survival (LFS) at 10 years from HSCT2 were 10±2 and 7±2%, respectively. Cumulative 10-year incidence of relapse and non-relapse mortality were 58±3% and 35±3%, respectively. CR at HSCT2, an interval from first transplant to relapse >10 months and TBI as part of the conditioning for HSCT2 favorably influenced LFS and OS. Patients with all three favorable factors had a 10-year OS of 36±10% and LFS of 25±9%, whereas patients showing no favorable factor had all died before year 5. Although retrospective, the long follow-up of this analysis supports the curative potential of alloHSCT2 in selected patients, who might be identified in advance, based on prognostic factors.

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Acknowledgements

According to the rules of EBMT, centers contributing the highest number of patients to the analysis are offered co-authorship. Beyond this, the authors thank the following EBMT centers for their contribution of data that enabled us to perform this study. Angers (CHRU), Ankara (Ibni Sina H), Antwerp (AZ Stuivenberg), Athens (Evangelismos H), Barcelona (S Creu I S Pau), Barcelona (H Clinic), Barcelona (H Univ Bellvitge), Basel, Belfast (City H), Berlin (Benjamin Franklin), Berlin (Charite Univ), Besancon (H Jean Minioz), Birmingham (Queen Elizabeth), Brescia (Spedali Civili), Bristol (Royal H Sick Children), Brugge (AZ Sint-Jan), Brussels (Jules Bordet), Brussels (St Luc), Brussels (Univ H), Cagliari (R Binaghi), Catania (Osp Ferrarotto), Clermont-Ferrand (Jean Perrin), Christchurch (Canterbury Health), Copenhagen (Rigshospitalet), Creteil (H Mondr Hematol), Dublin (St James), Düsseldorf (Heinrich Heine Univ), Freiburg (University), Geneva, Genova (S Martino), Gent (Univ H), Glasgow (Royal Infirmary), Graz (Medical Univ), Grenoble (H A Michallon), Hamburg (Univ H), Hannover (Medical Univ), Hradec Králové (Charles Univ H, Hematol), Helsinky (Univ Central H), Idar-Oberstein (Kl Knochenmarktr), Innsbruck (Univ H) Instanbul (Tip Fakueltesi), Jerusalem (Univ Hadassah), Katawice (Silesian Med Acad), Kiel (UKSH), Leicester (Royal Infirmary), Leiden (Univ H), Leipzig (Univ. Haemat/Oncol), Leuven (Univ H), Liege (University), Lille (H Claude Huriez), Linköping (Univ H), Liverpool (Royal Univ H), Ljubljiana (Univ Med Ctr), London (Royal Free), London (Royal Marsden), London (UCL), Madrid (Puerta de HIerro), Manchester (Royal Infirmary), Mainz (Johannes-Gutenberg), Marburg (Philipps Univ), Melbourne (Alfred H), Milano (Osp Maggiore), Montpellier (Univerisity), Munich (Kl Grosshadern), Munster (Univerisity), Murcia (H M Meseguer), Nijmegen (St Radboud), Palermo (Osp V Cervello), Palermo (Univ), Pamplona (Cl Univ Navarra), Paris (H Necker), Paris (Pitie-Salpetrriere), Paris (St. Antoine), Paris (St Louis), Parma (Centro Trapianti), Pavia (S Matteo), Perth (Royal H), Pesaro (Osp. Transplant Ctr), Pitiers (H La Miletrie), Porto (Inst Oncologia), Prague (Ist Hematology), Regensburg (University), Rome (Emat. ‘La Sapienza’), Rome (S Camillo-Forlanini), Rome (Tor Vergata), Rotterdam (Erasmus den Hoed), Rouen (Becquerel), Salamanca (H Clinico), Saint Etienne (St Etienne), San Giovanni Rotondo (IRCCS), Santander (Valdecilla), Stockholm (Univ H), Strasbourg (H Hautepierre), Sydney (Children’s H Westmead), Taranto (Osp Nord), Thessaloniki (G Papanicolaou G H), Toulouse (H Purpan), Trabzon (Karadeniz Tech Univ), Torino (209 S. Giovanni –CTO), Trieste (Ist Burlo Garofolo), Tubingen (Univ Tubigen), Turku (University), Ulm (Medizin Kl/Polikl), Uppasala (Univ H), Utrecht (University), Valencia (Infantile La Fe), Valencia (H Univ La Fe), Verona (Policlinico), Vienna (Medizinsche Univ), Villejuif (Goustave Roussy), Wiesbadn (Kl Diagnostik) and Zagreb (Univ H Rebro).

Author information

Author notes

  1. C Schmid and M Mohty: CS, AN and MM share senior authorship.

Authors and Affiliations

  1. Haematoncology Division, European Institute of Oncology, Milan, Italy

    G Andreola & D Laszlo

  2. EBMT Acute Leukemia Working Party office and AP-HP, Service d’Hématologie et Thérapie Cellulaire, Hopital Saint-Antoine, Sorbonne Universités, UPMC Univ Paris 06, and INSERM, UMR_S 938, CDR Saint-Antoine, Paris, France

    M Labopin, E Polge & M Mohty

  3. Department of Bone Marrow Transplantation, University Hospital Essen, Essen, Germany

    D Beelen

  4. Hematology Department, Center Hospitalier Universitaire (CHU) de Nantes, Nantes, France

    P Chevallier

  5. Service d’Hematologie Clinique et Therapie Cellulaire, Centre Hospitalier et Universitaire de Bordeaux, Bordeaux, France

    R Tabrizi

  6. Hematology Section, Careggi Hospital and University of Florence, Florence, Italy

    A Bosi

  7. Hematology Department, University Hospital Center, Lyon, France

    M Michallet

  8. Department of Hematology, Bone Marrow Transplant Center, Spirito Santo Hospital, Pescara, Italy

    S Santarone

  9. Department of Medicine I, University Hospital Carl Gustav Carus, Dresden, Germany

    G Ehninger

  10. Section for Hematopoietic Stem Cell Transplantation, Klinikum Augsburg, University of Munich, Munich, Germany

    C Schmid

  11. Hematology Division, Tel-Aviv University, Sheba Medical Center, Tel-Hashomer, Israel

    A Nagler

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  1. G Andreola
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Corresponding author

Correspondence to G Andreola.

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Andreola, G., Labopin, M., Beelen, D. et al. Long-term outcome and prognostic factors of second allogeneic hematopoietic stem cell transplant for acute leukemia in patients with a median follow-up of ⩾10 years. Bone Marrow Transplant 50, 1508–1512 (2015). https://doi.org/10.1038/bmt.2015.193

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  • DOI: https://doi.org/10.1038/bmt.2015.193

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