Prognostic factors for survival in children who relapsed after allogeneic hematopoietic stem cell transplantation for acute leukemia

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dc.contributor.authorHazar, Volkan
dc.contributor.authorTezcan Karasu, Gülsün
dc.contributor.authorÖztürk, Gülyüz
dc.contributor.authorKüpesiz, Alphan
dc.contributor.authorAksoylar, Serap
dc.contributor.authorÖzbek, Namık
dc.contributor.authorGökçe, Müge
dc.contributor.authorFışgın, Tunç
dc.date.accessioned2021-05-15T11:33:20Z
dc.date.available2021-05-15T11:33:20Z
dc.date.issued2021
dc.departmentTıp Fakültesien_US
dc.descriptionAksu, Tekin/0000-0003-4968-109X; Hazar, Volkan/0000-0002-1407-2334
dc.description.abstractBackground Post-transplant relapse has a dismal prognosis in children with acute leukemia undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT). Data on risk factors, treatment options, and outcomes are limited. Procedure In this retrospective multicenter study in which a questionnaire was sent to all pediatric transplant centers reporting relapse after allo-HSCT for a cohort of 938 children with acute leukemia, we analyzed 255 children with relapse of acute leukemia after their first allo-HSCT. Results The median interval from transplantation to relapse was 180 days, and the median follow-up from relapse to the last follow-up was 1844 days. The 3-year overall survival (OS) rate was 12.0%. The main cause of death was disease progression or subsequent relapse (82.6%). The majority of children received salvage treatment with curative intent without a second HSCT (67.8%), 22.0% of children underwent a second allo-HSCT, and 10.2% received palliative therapy. Isolated extramedullary relapse (hazard ratio (HR): 0.607, P = .011) and relapse earlier than 365 days post-transplantation (HR: 2.101, P < .001 for 0-180 days; HR: 1.522, P = .041 for 181-365 days) were found in multivariate analysis to be significant prognostic factors for outcome. The type of salvage therapy in chemosensitive relapse was identified as a significant prognostic factor for OS. Conclusion A salvage approach with curative intent may be considered for patients with post-transplant relapse, even if they relapse in the first year post-transplantation. For sustainable remission, a second allo-HSCT may be recommended for patients who achieve complete remission after reinduction treatment.en_US
dc.identifier.doi10.1111/petr.13942
dc.identifier.issn1397-3142
dc.identifier.issn1399-3046
dc.identifier.pmid33320995
dc.identifier.scopus2-s2.0-85097562815
dc.identifier.scopusqualityQ2
dc.identifier.urihttps://doi.org/10.1111/petr.13942
dc.identifier.urihttps://hdl.handle.net/20.500.12939/135
dc.identifier.wosWOS:000598672000001
dc.identifier.wosqualityQ3
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorFışgın, Tunç
dc.language.isoen
dc.publisherWileyen_US
dc.relation.ispartofPediatric Transplantation
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectAcute Leukemiaen_US
dc.subjectChildrenen_US
dc.subjectPost&#8208en_US
dc.subjectTransplant Relapseen_US
dc.subjectTreatmenten_US
dc.titlePrognostic factors for survival in children who relapsed after allogeneic hematopoietic stem cell transplantation for acute leukemia
dc.typeArticle

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