Second reduced intensity conditioning allogeneic transplant as a rescue strategy for acute leukaemia patients who relapse after an initial RIC allogeneic transplantation: analysis of risk factors and treatment outcomes

Limited therapeutic options are available after relapse of acute leukaemia following first reduced intensity conditioning haematopoietic stem cell transplantation (RIC1). A retrospective study on European Society for Blood and Marrow Transplantation (EBMT) registry data was performed on 234 adult pa...

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Main Authors: Vrhovac, Radovan (Author) , Labopin, M. (Author) , Ciceri, F. (Author) , Finke, J. (Author) , Holler, E. (Author) , Tischer, J. (Author) , Lioure, B. (Author) , Gribben, J. (Author) , Kanz, L. (Author) , Blaise, D. (Author) , Dreger, Peter (Author) , Held, G. (Author) , Arnold, R. (Author) , Nagler, A. (Author) , Mohty, M. (Author)
Format: Article (Journal)
Language:English
Published: [2016]
In: Bone marrow transplantation
Year: 2015, Volume: 51, Issue: 2, Pages: 186-193
ISSN:1476-5365
DOI:10.1038/bmt.2015.221
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1038/bmt.2015.221
Verlag, lizenzpflichtig, Volltext: https://www.nature.com/articles/bmt2015221
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Author Notes:R. Vrhovac, M. Labopin, F. Ciceri, J. Finke, E. Holler, J. Tischer, B. Lioure, J. Gribben, L. Kanz, D. Blaise, P. Dreger, G. Held, R. Arnold, A. Nagler and M. Mohty on behalf of the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation (EBMT)

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520 |a Limited therapeutic options are available after relapse of acute leukaemia following first reduced intensity conditioning haematopoietic stem cell transplantation (RIC1). A retrospective study on European Society for Blood and Marrow Transplantation (EBMT) registry data was performed on 234 adult patients with acute leukaemia who received a second RIC transplantation (RIC2) from 2000 to 2012 as a salvage treatment for relapse following RIC1. At the time of RIC2, 167 patients (71.4%) had relapsed or refractory disease, 49 (20.9%) were in second CR and 18 (7.7%) in third or higher CR. With a median follow-up of 21 (1.5-79) months after RIC2, 51 patients are still alive. At 2 years, the cumulative incidence of non-relapse mortality (NRM), relapse incidence (RI), leukaemia-free survival (LFS) and overall survival (OS) were 22.4% (95% confidence interval (CI): 17-28.4), 63.9% (56.7-70.1), 14.6% (8.8-18.5) and 20.5% (14.9-26.1), respectively. In patients with acute myelogenous, biphenotypic and undifferentiated leukaemia (representing 89.8% of all patients), duration of remission following RIC1 >225 days, presence of CR at RIC2, patient’s Karnofsky performance status >80 at RIC2 and non-myeloablative conditioning were found to be the strongest predictors of patients’ favourable outcome. 
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