Treatment of relapse after allogeneic stem cell transplantation in children and adolescents with ALL: the Frankfurt experience
| Autor: | Jan Soerensen, Melanie Bremm, J Opper, Evelyn Ullrich, Matthias Duerken, Andre Willasch, Peter Bader, R Bager, Thomas Krenn, Michael Merker, Hermann Kreyenberg, Emilia Salzmann-Manrique, Jörg Faber, Sabine Huenecke, Claudia Cappel, T. Klingebiel, Shahrzad Bakhtiar, Eva Rettinger, Verena Pfirrmann, Andrea Jarisch |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Lymphocyte Transfusion Adolescent medicine.medical_treatment 03 medical and health sciences 0302 clinical medicine Recurrence Germany medicine Humans Progenitor cell Child Retrospective Studies Transplantation Chemotherapy business.industry Infant Retrospective cohort study Hematology Immunotherapy Precursor Cell Lymphoblastic Leukemia-Lymphoma Allografts medicine.disease Tissue Donors Surgery Clinical trial surgical procedures operative Graft-versus-host disease Child Preschool 030220 oncology & carcinogenesis Female business Stem Cell Transplantation 030215 immunology |
| Zdroj: | Bone Marrow Transplantation. 52:201-208 |
| ISSN: | 1476-5365 0268-3369 |
| DOI: | 10.1038/bmt.2016.224 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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