Transplantation Outcomes for Children with Hypodiploid Acute Lymphoblastic Leukemia.
Submitted by Eneida R Nemecek on
Title | Transplantation Outcomes for Children with Hypodiploid Acute Lymphoblastic Leukemia. |
Publication Type | Journal Article |
Year of Publication | 2015 |
Authors | Mehta, PA, Zhang, M-J, Eapen, M, He, W, Seber, A, Gibson, B, Camitta, BM, Kitko, CL, Dvorak, CC, Nemecek, ER, Frangoul, HA, Abdel-Azim, H, Kasow, KA, Lehmann, L, Vicent, MGonzalez, Pérez, MADiaz, Ayas, M, Qayed, M, Carpenter, PA, Jodele, S, Lund, TC, Leung, WH, Davies, SM |
Journal | Biol Blood Marrow Transplant |
Volume | 21 |
Issue | 7 |
Pagination | 1273-7 |
Date Published | 2015 Jul |
ISSN | 1523-6536 |
Keywords | Acute Disease, Adolescent, Aneuploidy, Child, Child, Preschool, Female, Graft vs Host Disease, Hematopoietic Stem Cell Transplantation, Humans, Immunosuppressive Agents, Male, Myeloablative Agonists, Precursor Cell Lymphoblastic Leukemia-Lymphoma, Recurrence, Remission Induction, Retrospective Studies, Risk, Siblings, Survival Analysis, Transplantation Conditioning, Transplantation, Homologous, Treatment Outcome, Unrelated Donors |
Abstract | Children with hypodiploid acute lymphoblastic leukemia (ALL) have inferior outcomes despite intensive risk-adapted chemotherapy regimens. We describe 78 children with hypodiploid ALL who underwent hematopoietic stem cell transplantation between 1990 and 2010. Thirty-nine (50%) patients had ≤ 43 chromosomes, 12 (15%) had 44 chromosomes, and 27 (35%) had 45 chromosomes. Forty-three (55%) patients underwent transplantation in first remission (CR1) and 35 (45%) underwent transplantation in ≥ second remission (CR2). Twenty-nine patients (37%) received a graft from a related donor and 49 (63%) from an unrelated donor. All patients received a myeloablative conditioning regimen. The 5-year probabilities of leukemia-free survival, overall survival, relapse, and treatment-related mortality for the entire cohort were 51%, 56%, 27%, and 22%, respectively. Multivariate analysis confirmed that mortality risks were higher for patients who underwent transplantation in CR2 (hazard ratio, 2.16; P = .05), with number of chromosomes ≤ 43 (hazard ratio, 2.15; P = .05), and for those who underwent transplantation in the first decade of the study period (hazard ratio, 2.60; P = .01). Similarly, treatment failure risks were higher with number of chromosomes ≤ 43 (hazard ratio, 2.28; P = .04) and the earlier transplantation period (hazard ratio, 2.51; P = .01). Although survival is better with advances in donor selection and supportive care, disease-related risk factors significantly influence transplantation outcomes. |
DOI | 10.1016/j.bbmt.2015.04.008 |
Alternate Journal | Biol. Blood Marrow Transplant. |
PubMed ID | 25865650 |
PubMed Central ID | PMC4465998 |
Grant List | U10 HL069294 / HL / NHLBI NIH HHS / United States U24 CA076518 / CA / NCI NIH HHS / United States HHSH250201200016C / / PHS HHS / United States 5U10HL069294 / HL / NHLBI NIH HHS / United States U24-CA076518 / CA / NCI NIH HHS / United States |