How risky is a second allogeneic stem cell transplantation?
There is no consensus on second allogeneic stem cell transplantation (alloSCT) indications in patients with hematologic malignancies relapsing after a first alloSCT. In historic publications, a very high non-relapse mortality (NRM) has been described, arguing against performing a second alloSCT. We...
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| Hauptverfasser: | , , , , , , , , , , , , , , , , , |
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| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
25 June 2024
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| In: |
Leukemia
Year: 2024, Jahrgang: 38, Heft: 8, Pages: 1799-1807 |
| ISSN: | 1476-5551 |
| DOI: | 10.1038/s41375-024-02318-3 |
| Online-Zugang: | Verlag, kostenfrei, Volltext: https://doi.org/10.1038/s41375-024-02318-3
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| Verfasserangaben: | Olaf Penack, Mouad Abouqateb, Christophe Peczynski, William Boreland, Nicolaus Kröger, Robert Zeiser, Fabio Ciceri, Thomas Schroeder, Peter Dreger, Jakob Passweg, Johannes Schetelig, Matthias Stelljes, Igor Wolfgang Blau, Georg-Nikolaus Franke, Katarina Riesner, Hélène Schoemans, Ivan Moiseev and Zinaida Peric |
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| 245 | 1 | 0 | |a How risky is a second allogeneic stem cell transplantation? |c Olaf Penack, Mouad Abouqateb, Christophe Peczynski, William Boreland, Nicolaus Kröger, Robert Zeiser, Fabio Ciceri, Thomas Schroeder, Peter Dreger, Jakob Passweg, Johannes Schetelig, Matthias Stelljes, Igor Wolfgang Blau, Georg-Nikolaus Franke, Katarina Riesner, Hélène Schoemans, Ivan Moiseev and Zinaida Peric |
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| 520 | |a There is no consensus on second allogeneic stem cell transplantation (alloSCT) indications in patients with hematologic malignancies relapsing after a first alloSCT. In historic publications, a very high non-relapse mortality (NRM) has been described, arguing against performing a second alloSCT. We analysed the outcome of 3356 second alloSCTs performed 2011-21 following a hematologic malignancy relapse. Outcomes at two years after second alloSCT were: NRM 22%, relapse incidence 50%, overall survival 38%, and progression-free survival 28%. Key risk factors for increased NRM were: older age, low performance score, high disease-risk-index, early relapse after the first alloSCT, unrelated/haploidentical donor, and GVHD before second alloSCT. Any type of GVHD after first alloSCT was also important risk factor for acute GVHD and chronic GVHD after second alloSCT. There was a preferential use of a different donor (80%) at second alloSCT from first alloSCT. However, in multivariate analysis, the use of the same alloSCT donor for second alloSCT vs. a different donor was not associated with any of the survival or GVHD endpoints. We show considerably improved outcome as compared to historic reports. These current data support a wider use of second alloSCT and provide risk factors for NRM that need to be considered. | ||
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| 650 | 4 | |a Neoplasm Recurrence, Local | |
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