Universität zu Köln

Christopeit, Maximilian ORCID: 0000-0003-4627-0412, Kuss, Oliver ORCID: 0000-0003-3301-5869, Finke, Juergen, Bacher, Ulrike, Beelen, Dietrich Wilhelm, Bornhaeuser, Martin, Schwerdtfeger, Rainer, Bethge, Wolfgang Andreas, Basara, Nadezda, Gramatzki, Martin, Tischer, Johanna, Kolb, Hans-Jochem, Uharek, Lutz, Meyer, Ralf G., Bunjes, Donald, Scheid, Christof, Martin, Hans, Niederwieser, Dietger, Kroeger, Nicolaus, Bertz, Hartmut, Schrezenmeier, Hubert and Schmid, Christoph (2013). Second Allograft for Hematologic Relapse of Acute Leukemia After First Allogeneic Stem-Cell Transplantation From Related and Unrelated Donors: The Role of Donor Change. J. Clin. Oncol., 31 (26). S. 3259 - 3276. ALEXANDRIA: AMER SOC CLINICAL ONCOLOGY. ISSN 1527-7755

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Abstract

Purpose To evaluate the role of a second allogeneic hematopoietic stem-cell transplantation (HSCT2) given for relapsed acute leukemia (AL) after related or unrelated first hematopoietic stem-cell transplantation (HSCT1) and to analyze the role of donor change for HSCT2 in both settings. Patients and Methods We performed a retrospective registry study on 179 HSCT2s given for relapse after HSCT1 from matched related donors (n = 75) or unrelated donors (n = 104), using identical or alternative donors for HSCT2. Separate analyses were performed according to donor at HSCT1. Results Independent of donor, 74% of patients achieved complete remission after HSCT2, and half of these patients experienced relapse again. Overall survival (OS) at 2 years was 25% +/- 4% (39% +/- 7% after related HSCT2; 19% +/- 4% after unrelated HSCT2). Long-term survivors were observed even after two unrelated HSCT2s. Multivariate analysis for OS from HSCT2 confirmed established risk factors (remission duration after HSCT1: hazard ratio [HR], 2.37; 95% CI, 1.61 to 3.46; P < .001; stage at HSCT2: HR, 0.53; 95% CI, 0.34 to 0.83; P = .006). Outcome of HSCT2 was better after related HSCT1 than after unrelated HSCT1 (2-year OS: 37% +/- 6% v 16% +/- 4%, respectively; HR, 0.68; 95% CI, 0.47 to 0.98; P = .042, multivariate Cox regression). After both related and unrelated HSCT1, selecting a new donor for HSCT2 did not result in a relevant improvement in OS compared with HSCT2 from the original donor; however, donor change was not detrimental either. Conclusion After relapse from allogeneic HSCT1, HSCT2 can induce 2-year OS in approximately 25% of patients. Unrelated HSCT2 is feasible after related and unrelated HSCT1. Donor change for HSCT2 is a valid option. However, a clear advantage in terms of OS could not be demonstrated. (C) 2013 by American Society of Clinical Oncology

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Christopeit, Maximilian UNSPECIFIED orcid.org/0000-0003-4627-0412 UNSPECIFIED Kuss, Oliver UNSPECIFIED orcid.org/0000-0003-3301-5869 UNSPECIFIED Finke, Juergen UNSPECIFIED UNSPECIFIED UNSPECIFIED Bacher, Ulrike UNSPECIFIED UNSPECIFIED UNSPECIFIED Beelen, Dietrich Wilhelm UNSPECIFIED UNSPECIFIED UNSPECIFIED Bornhaeuser, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Schwerdtfeger, Rainer UNSPECIFIED UNSPECIFIED UNSPECIFIED Bethge, Wolfgang Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Basara, Nadezda UNSPECIFIED UNSPECIFIED UNSPECIFIED Gramatzki, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Tischer, Johanna UNSPECIFIED UNSPECIFIED UNSPECIFIED Kolb, Hans-Jochem UNSPECIFIED UNSPECIFIED UNSPECIFIED Uharek, Lutz UNSPECIFIED UNSPECIFIED UNSPECIFIED Meyer, Ralf G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bunjes, Donald UNSPECIFIED UNSPECIFIED UNSPECIFIED Scheid, Christof UNSPECIFIED UNSPECIFIED UNSPECIFIED Martin, Hans UNSPECIFIED UNSPECIFIED UNSPECIFIED Niederwieser, Dietger UNSPECIFIED UNSPECIFIED UNSPECIFIED Kroeger, Nicolaus UNSPECIFIED UNSPECIFIED UNSPECIFIED Bertz, Hartmut UNSPECIFIED UNSPECIFIED UNSPECIFIED Schrezenmeier, Hubert UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmid, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-476008
DOI:	10.1200/JCO.2012.44.7961
Journal or Publication Title:	J. Clin. Oncol.
Volume:	31
Number:	26
Page Range:	S. 3259 - 3276
Date:	2013
Publisher:	AMER SOC CLINICAL ONCOLOGY
Place of Publication:	ALEXANDRIA
ISSN:	1527-7755
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language BONE-MARROW-TRANSPLANTATION; ACUTE MYELOID-LEUKEMIA; ACUTE MYELOGENOUS LEUKEMIA; CONDITIONING REGIMEN; LEUKOCYTE INFUSIONS; MYELODYSPLASTIC SYNDROME; LYMPHOCYTE INFUSIONS; WORKING PARTY; RISK-FACTORS; TOTAL-BODY Multiple languages Oncology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/47600