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

Michael J. Burke, Michael R. Verneris, Jennifer Le Rademacher, Wensheng He, Hisham Abdel-Azim, Allistair A. Abraham, Jeffery J. Auletta, Mouhab Ayas, Valerie I. Brown, Mitchell S. Cairo, Ka Wah Chan, Miguel A. Diaz Perez, Christopher C. Dvorak, R. Maarten Egeler, Lamis Eldjerou, Haydar Frangoul, Gregory M T Guilcher, Robert J. Hayashi, Ahmed Ibrahim, Kimberly A. KasowWing H. Leung, Richard F. Olsson, Michael A. Pulsipher, Niketa Shah, Nirali N. Shah, Elizabeth Thiel, Julie An Talano, Carrie L. Kitko

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

Survival for children with relapsed T cell acute lymphoblastic leukemia (T-ALL) is poor when treated with chemotherapy alone, and outcomes after allogeneic hematopoietic cell transplantation (HCT) is not well described. Two hundred twenty-nine children with T-ALL in second complete remission (CR2) received an HCT after myeloablative conditioning between 2000 and 2011 and were reported to the Center for International Blood and Marrow Transplant Research. Median age was 10 years (range, 2 to 18). Donor source was umbilical cord blood (26%), matched sibling bone marrow (38%), or unrelated bone marrow/peripheral blood (36%). Acute (grades II to IV) and chronic graft-versus-host disease occurred in, respectively, 35% (95% confidence interval [CI], 27% to 45%) and 26% (95% CI, 20% to 33%) of patients. Transplant-related mortality at day 100 and 3-year relapse rates were 13% (95% CI, 9% to 18%) and 30% (95% CI, 24% to 37%), respectively. Three-year overall survival and disease-free survival rates were 48% (95% CI, 41% to 55%) and 46% (95% CI, 39% to 52%), respectively. In multivariate analysis, patients with bone marrow relapse, with or without concurrent extramedullary relapse before HCT, were most likely to relapse (hazard ratio, 3.94; P = .005) as compared with isolated extramedullary disease. In conclusion, HCT for pediatric T-ALL in CR2 demonstrates reasonable and durable outcomes, and consideration for HCT is warranted.

Original languageEnglish (US)
Pages (from-to)2154-2159
Number of pages6
JournalBiology of Blood and Marrow Transplantation
Volume21
Issue number12
DOIs
StatePublished - Dec 2015

Keywords

  • Acute lymphoblastic leukemia
  • Pediatric
  • Relapse
  • T-cell ALL
  • Transplantation

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