Different kinetics and risk factors for ısolated extramedullary relapse after allogeneic hematopoietic stem cell transplantation in children with acute leukemia

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dc.contributor.authorHazar, Volkan
dc.contributor.authorÖztürk, Gülyüz
dc.contributor.authorYalçın, Koray
dc.contributor.authorUygun, Vedat
dc.contributor.authorAksoylar, Serap
dc.contributor.authorKüpesiz, A.
dc.contributor.authorOk Bozkaya, İkbal
dc.contributor.authorKaragün, Barbaros Şahin
dc.contributor.authorİleri, Talia
dc.contributor.authorAtay, Didem
dc.contributor.authorKoçak, Ülker
dc.contributor.authorTezcan Karasu, Gülsün
dc.contributor.authorYeşilipek, Akif
dc.contributor.authorGökçe, Müge
dc.contributor.authorKansoy, Savaş
dc.contributor.authorTüysüz Kintrup, Gülen
dc.contributor.authorKarakükçü, Musa
dc.contributor.authorVisal Okur, Fatma
dc.contributor.authorErtem, Mehmet
dc.contributor.authorKaya, Zühre
dc.contributor.authorGürsel, Orhan
dc.contributor.authorYaman, Yöntem
dc.contributor.authorÖzbek, Namık
dc.contributor.authorAntmen, Bülent
dc.contributor.authorTüfekçi, Özlem
dc.contributor.authorAlbayrak, Canan
dc.contributor.authorAdaklı Aksoy, Başak
dc.contributor.authorSezgin, Gülay
dc.contributor.authorAlbayrak, Davut
dc.contributor.authorSezgin Evim, Melike
dc.contributor.authorZengin, Emine
dc.contributor.authorPekpak, Esra
dc.contributor.authorTurkish Pediatric Bone Marrow Transplantation Study Group
dc.date.accessioned2022-01-07T07:25:05Z
dc.date.available2022-01-07T07:25:05Z
dc.date.issued2021en_US
dc.departmentFakülteler, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümüen_US
dc.description.abstractRelapse after allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains the most frequent cause ofpost-transplantation mortality. Isolated extramedullary (EM) relapse (iEMR) after HSCT is relatively rare and notwell characterized, particularly in pediatric patients. We retrospectively analyzed 1527 consecutive pediatricpatients with acute leukemia after allo-HSCT to study the incidence, risk factors, and outcome of iEMR comparedwith systemic relapse. The 5-year cumulative incidence of systemic relapse (either bone marrow [BM] only or BMcombined with EMR) was 24.8%, and that of iEMR was 5.5%. The onset of relapse after allo-HSCT was significantlylonger in EM sites than in BM sites (7.19 and 5.58 months, respectively;P= .013). Complete response (CR) 2+/active disease at transplantation (hazard ratio [HR], 3.1;P<.001) and prior EM disease (HR, 2.3;P= .007) were independent risk factors for iEMR. Chronic graft-versus-host disease reduced the risk of systemic relapse (HR, 0.5;P= .043) but did not protect against iEMR. The prognosis of patients who developed iEMR remained poor but wasslightly better than that of patients who developed systemic relapse (3-year overall survival, 16.5% versus 15.3%;P= .089). Patients experiencing theirfirst systemic relapse continued to have further systemic relapse, but only aminority progressed to iEMR, whereas those experiencing their iEMR atfirst relapse developed further systemicrelapse and iEMR at approximately similar frequencies. A second iEMR was more common after afirst iEMR thanafter afirst systemic relapse (58.8% versus 13.0%;P= .001) and was associated with poor outcome. iEMR has apoor prognosis, particularly after a second relapse, and effective strategies are needed to improve outcomes.© 2021 The American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc. All rights reserved.en_US
dc.identifier.citationHazar, V., Öztürk, G., Yalçın, K., Uygun, V., Aksoylar, S., Küpesiz, A., ... Turkish Pediatric Bone Marrow Transplantation Study Group. (2021). Different kinetics and risk factors for isolated extramedullary relapse after allogeneic hematopoietic stem cell transplantation in children with acute leukemia. Transplantation and Cellular Therapy, 27(10), 859-e1.en_US
dc.identifier.endpage859.e10en_US
dc.identifier.issue10en_US
dc.identifier.scopus2-s2.0-85111517361
dc.identifier.scopusqualityQ1
dc.identifier.startpage859.e1en_US
dc.identifier.urihttps://hdl.handle.net/20.500.12939/2111
dc.identifier.volume27en_US
dc.identifier.wosWOS:000701826600014
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.institutionauthorBozkurt, Ceyhun
dc.language.isoen
dc.publisherElsevieren_US
dc.relation.ispartofTransplantation and Cellular Therapy
dc.relation.isversionof10.1016/j.jtct.2021.06.023en_US
dc.relation.publicationcategoryMakale - Ulusal Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectAcute Leukemiaen_US
dc.subjectPost-Transplantation Relapseen_US
dc.subjectChildrenen_US
dc.titleDifferent kinetics and risk factors for ısolated extramedullary relapse after allogeneic hematopoietic stem cell transplantation in children with acute leukemia
dc.typeArticle

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