Treatment of relapse after allogeneic stem cell transplantation in children and adolescents with ALL: the Frankfurt experience
Therapy for post-transplant relapse of paediatric ALL is limited. Standardised curative approaches are not available. We hereby describe our local procedure in this life-threatening situation. A total of 101 ALL patients received their first allogeneic stem cell transplantation (SCT) in our institut...
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| Main Authors: | , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
2017
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| In: |
Bone marrow transplantation
Year: 2017, Volume: 52, Issue: 2, Pages: 201-208 |
| ISSN: | 1476-5365 |
| DOI: | 10.1038/bmt.2016.224 |
| Online Access: | Verlag, Volltext: http://dx.doi.org/10.1038/bmt.2016.224 Verlag, Volltext: https://www-nature-com.ezproxy.medma.uni-heidelberg.de/articles/bmt2016224 
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| Author Notes: | A.M. Willasch, E. Salzmann-Manrique, T. Krenn, M. Duerken, J. Faber, J. Opper, H. Kreyenberg, R. Bager, S. Huenecke, C. Cappel, M. Bremm, V. Pfirrmann, M. Merker, E. Ullrich, S. Bakhtiar, E. Rettinger, A. Jarisch, J. Soerensen, T.E. Klingebiel and P. Bader |
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| 520 | |a Therapy for post-transplant relapse of paediatric ALL is limited. Standardised curative approaches are not available. We hereby describe our local procedure in this life-threatening situation. A total of 101 ALL patients received their first allogeneic stem cell transplantation (SCT) in our institution. After relapse, our primary therapeutic goal was to cure the patient with high-dose chemotherapy or specific immunotherapy (HDCHT/SIT) followed by a second SCT from a haploidentical donor (transplant approach). If this was not feasible, low-dose chemotherapy and donor lymphocyte infusions (LDCHT+DLI) were offered (non-transplant approach). A total of 23 patients suffered a post-transplant relapse. Eight patients received HDCHT/SIT, followed by haploidentical SCT in 7/8. Ten received LDCHT+DLI. The eight patients treated with a second transplant and the ten treated with the non-transplant approach had a 4-year overall survival of 56% and 40%, respectively (P=0.232). Prerequisites for successful treatment of post-transplant relapse by either a second transplant or experimental non-transplant approaches are good clinical condition and the capacity to achieve haematological remission by the induction treatment element. | ||
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