Second hematopoietic stem cell transplantation in pediatric patients: Overall survival and long-term follow-up

Autor: Ami J Shah, Neena Kapoor, Kenneth I Weinberg, Gay M Crooks, Donald B Kohn, Carl Lenarsky, Francine Kaufman, Karen Epport, Kathy Wilson, Robertson Parkman
Rok vydání: 2002
Předmět:
Graft Rejection
Male
Neoplasms
Radiation-Induced
Transplantation Conditioning
T-Lymphocytes
medicine.medical_treatment
Hematopoietic stem cell transplantation
0302 clinical medicine
Femur Head Necrosis
Recurrence
Life Tables
Survivors
Child
Osteosarcoma
Human Growth Hormone
Graft Survival
Neoplasms
Second Primary
Hematology
3. Good health
surgical procedures
operative
Child
Preschool
Hematologic Neoplasms
030220 oncology & carcinogenesis
Toxicity
Female
Thyroid function
medicine.medical_specialty
Adolescent
Bone Neoplasms
Red-Cell Aplasia
Pure
Malignancy
03 medical and health sciences
Immune system
Hypothyroidism
Internal medicine
medicine
Overall survival
Humans
Endocrine system
Anodontia
Peripheral Blood Stem Cell Transplantation
Transplantation
business.industry
Hypogonadism
Infant
medicine.disease
Survival Analysis
Surgery
Dentition
Permanent
Cognition Disorders
business
Follow-Up Studies
030215 immunology
Zdroj: Biology of Blood and Marrow Transplantation. 8:221-228
ISSN: 1083-8791
Popis: Despite potent intensive conditioning regimens, hematopoietic stem cell transplantation (HSCT) may fail because of either relapse of the malignancy or the rejection of the graft. We report on 27 pediatric patients who received a second HSCT from an allogeneic donor for relapsed malignancy or graft failure. One-year, 5-year, and 10-year probabilities of survival for all patients were 53%, 36%, and 24%, respectively. Twenty patients received second HSCTs for relapsed malignancy, of whom 6 were alive and disease free at the time of this report. Seven patients received a second HSCT for graft failure, of whom 3 were alive and well as of this report. Twenty-five patients were tested for immune reconstitution following their second HSCT. Sixteen patients developed antigen-specific T-lymphocyte responses; the median time to development of antigen-specific responses was 13 months. There was no significant neurocognitive decline in patients tested 1 to 3 years following their second HSCT. Endocrine evaluations revealed deficiencies in growth hormone (7 patients), gonadal function (3 patients), and thyroid function (2 patients). Three patients developed significant abnormalities of tooth development, including absence of secondary teeth. These results show that a second HSCT offers curative therapy for selected pediatric patients whose first HSCT failed. Although toxicity is considerable following a second transplantation, the major causes of mortality continue to be relapse and infection. Biol Blood Marrow Transplant 2002;8(4):221-8.
Databáze: OpenAIRE
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