Second allogeneic stem cell transplantation in myeloid malignancies.
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Second allogeneic stem cell transplantation in myeloid malignancies. / Hartwig, Maite; Ocheni, Sunday; Asenova, Svetlana; Wiedemann, Bettina; Zabelina, Tatjana; Ayuketang Ayuk, Francis; Kabisch, Hartmut; Erttmann, Rudolf; Kröger, Nicolaus; Zander, Axel R.; Bacher, Ulrike.
in: ACTA HAEMATOL-BASEL, Jahrgang 122, Nr. 4, 4, 2009, S. 185-192.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Second allogeneic stem cell transplantation in myeloid malignancies.
AU - Hartwig, Maite
AU - Ocheni, Sunday
AU - Asenova, Svetlana
AU - Wiedemann, Bettina
AU - Zabelina, Tatjana
AU - Ayuketang Ayuk, Francis
AU - Kabisch, Hartmut
AU - Erttmann, Rudolf
AU - Kröger, Nicolaus
AU - Zander, Axel R.
AU - Bacher, Ulrike
PY - 2009
Y1 - 2009
N2 - For patients with myeloid malignancies who relapse after allogeneic stem cell transplantation (allo-SCT), one salvage option is a second SCT. We retrospectively analyzed outcomes of the second allo-SCT in 25 patients who received at least 2 allografts from related/unrelated donors due to relapse of acute myeloid leukemia, myelodysplastic syndrome or myelofibrosis after the first SCT. A minority of the acute myeloid leukemia/myelodysplastic syndrome patients had reached complete hematological remission before the second SCT (6/25, 24%). Reduced conditioning strategies were performed in the majority (n = 23). Complete remission was achieved in all 21 cases with available data after the second SCT, but relapse was seen in 11/25 patients (44%). After a median follow-up of 18 months (range 6-47), 8/25 patients (32%) were still alive, and of those, 6 (24%) were in stable remission. In 9 cases mortality was associated to relapse and in 8 cases to transplant-related causes (treatment-related mortality; 8/25, 32%). In conclusion, a second SCT offers the chance of stable remission for some patients relapsing with a myeloid malignancy after a first allo-SCT, although high treatment-related mortality and relapse rates remain a problem. Efforts should concentrate on an optimization of conditioning strategies, immunosuppression and post-transplant surveillance for this specific situation.
AB - For patients with myeloid malignancies who relapse after allogeneic stem cell transplantation (allo-SCT), one salvage option is a second SCT. We retrospectively analyzed outcomes of the second allo-SCT in 25 patients who received at least 2 allografts from related/unrelated donors due to relapse of acute myeloid leukemia, myelodysplastic syndrome or myelofibrosis after the first SCT. A minority of the acute myeloid leukemia/myelodysplastic syndrome patients had reached complete hematological remission before the second SCT (6/25, 24%). Reduced conditioning strategies were performed in the majority (n = 23). Complete remission was achieved in all 21 cases with available data after the second SCT, but relapse was seen in 11/25 patients (44%). After a median follow-up of 18 months (range 6-47), 8/25 patients (32%) were still alive, and of those, 6 (24%) were in stable remission. In 9 cases mortality was associated to relapse and in 8 cases to transplant-related causes (treatment-related mortality; 8/25, 32%). In conclusion, a second SCT offers the chance of stable remission for some patients relapsing with a myeloid malignancy after a first allo-SCT, although high treatment-related mortality and relapse rates remain a problem. Efforts should concentrate on an optimization of conditioning strategies, immunosuppression and post-transplant surveillance for this specific situation.
M3 - SCORING: Zeitschriftenaufsatz
VL - 122
SP - 185
EP - 192
JO - ACTA HAEMATOL-BASEL
JF - ACTA HAEMATOL-BASEL
SN - 0001-5792
IS - 4
M1 - 4
ER -
