Outcome of children relapsing after first allogeneic haematopoietic stem cell transplantation for acute myeloid leukaemia: a retrospective I-BFM analysis of 333 children

Theodor Uden; Alice Bertaina; Jonas Abrahamsson; Marc Ansari; Adriana Balduzzi; Jean-Pierre Bourquin; Corinne Gerhardt; Marc Bierings; Henrik Hasle; Arjan Lankester; Kirsten Mischke; Andrew S Moore; Ian Nivison-Smith; Anna Pieczonka; Christina Peters; Petr Sedlacek; Dirk Reinhardt; Jerry Stein; Birgitta Versluys; Jacek Wachowiak; Leen Willems; Martin Zimmermann; Franco Locatelli; Martin G Sauer

doi:10.1111/bjh.16441

Outcome of children relapsing after first allogeneic haematopoietic stem cell transplantation for acute myeloid leukaemia: a retrospective I-BFM analysis of 333 children

Br J Haematol. 2020 May;189(4):745-750. doi: 10.1111/bjh.16441. Epub 2020 Feb 3.

Authors

Theodor Uden¹, Alice Bertaina², Jonas Abrahamsson³, Marc Ansari⁴, Adriana Balduzzi⁵, Jean-Pierre Bourquin⁶, Corinne Gerhardt⁷, Marc Bierings⁷, Henrik Hasle⁸, Arjan Lankester⁹, Kirsten Mischke¹, Andrew S Moore¹⁰, Ian Nivison-Smith¹¹, Anna Pieczonka¹², Christina Peters¹³, Petr Sedlacek¹⁴, Dirk Reinhardt¹⁵, Jerry Stein¹⁶, Birgitta Versluys¹⁷, Jacek Wachowiak¹², Leen Willems¹⁸, Martin Zimmermann¹, Franco Locatelli^{2

19}, Martin G Sauer¹

Affiliations

¹ Division of Pediatric Hematology and Oncology, Department of Pediatrics, Universities of Medical University Hannover, Hannover, Germany.
² IRCCS "Bambino Gesù" Children's Hospital, Rome, Italy.
³ Institution of Clinical Sciences, Sahlgrenska University Hospital, Gothenburg, Sweden.
⁴ Cansearch Research Laboratory, Geneva University Hospital, Geneva University, Geneva, Switzerland.
⁵ Clinica Pediatrica Università degli Studi di Milano Bicocca, Fondazione MBBM/Ospedale San Gerardo, Monza, Italy.
⁶ University Children's Hospital Zurich, CHE, Zurich, Switzerland.
⁷ Princess Maxima Centre for Pediatric Oncology, Childrens University Hospital Utrecht, Utrecht, Netherlands.
⁸ Aarhus University Hospital, Arhus, Sweden.
⁹ Willem Alexander Children's Hospital, Leiden University Medical Centre, Leiden, Netherlands.
¹⁰ Queensland Children's Hospital and The University of Queensland, Brisbane, QLD, Australia.
¹¹ Australasian Bone Marrow Transplant Recipient Registry, Darlinghurst, NSW, Australia.
¹² University of Medical Sciences, Poznan, Poland.
¹³ St Anna Childrens Hospital, Vienna, Austria.
¹⁴ University Hospital Motol, Charles University, Prague, Czech Republic.
¹⁵ University of Duisburg-Essen, Essen, Germany.
¹⁶ Schneider Children's Medical Center of Israel, Petach Tikva, Israel.
¹⁷ University Medical Center Utrecht, Utrecht, Netherlands.
¹⁸ Ghent University Hospital, Ghent, Belgium.
¹⁹ Sapienza, University of Rome, Rome, Italy.

PMID: 32012224
DOI: 10.1111/bjh.16441

Abstract

Outcome of 333 children with acute myeloid leukaemia relapsing after a first allogeneic haematopoietic stem cell transplantation was analyzed. Four-year probability of overall survival (4y-pOS) was 14%. 4y-pOS for 122 children receiving a second haematopoietic stem cell transplantation was 31% and 3% for those that did not (P = <0·0001). Achievement of a subsequent remission impacted survival (P = <0·0001). For patients receiving a second transplant survival with or without achieving a subsequent remission was comparable. Graft source (bone marrow vs. peripheral blood stem cells, P = 0·046) and donor choice (matched family vs. matched unrelated donor, P = 0·029) positively impacted survival after relapse. Disease recurrence and non-relapse mortality at four years reached 45% and 22%.

Keywords: acute myeloid leukemia; allogeneic hematopoietic stem cell transplantation; children; relapse; second hematopoietic stem cell transplantation.

MeSH terms

Child
Female
Hematopoietic Stem Cell Transplantation / methods*
Humans
Leukemia, Myeloid, Acute / mortality
Leukemia, Myeloid, Acute / pathology
Leukemia, Myeloid, Acute / therapy*
Male
Retrospective Studies
Survival Analysis
Transplantation Conditioning / methods*
Transplantation, Homologous / methods*