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Transplant Outcomes for Children with T Cell Acute Lymphoblastic Leukemia in Second Remission: A Report from the Center for International Blood and Marrow Transplant Research
Med Coll Wisconsin, Dept Pediat, Div Hematol Oncol Blood & Marrow Transplant, Milwaukee, WI 53226 USA.;Childrens Hosp Wisconsin, Milwaukee, WI 53226 USA..
Univ Minnesota, Dept Pediat, Minneapolis, MN 55455 USA..
Med Coll Wisconsin, Dept Med, CIBMTR, Milwaukee, WI 53226 USA.;Med Coll Wisconsin, Div Biostat, Inst Hlth & Soc, Milwaukee, WI 53226 USA..
Med Coll Wisconsin, Dept Med, CIBMTR, Milwaukee, WI 53226 USA..
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2015 (English)In: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 21, no 12, 2154-2159 p.Article in journal (Refereed) PublishedText
Abstract [en]

Survival for children with relapsed T cell acute lymphoblastic leukemia (T-ALL) is poor when treated with chemotherapy alone, and outcomes after allogeneic hematopoietic cell transplantation (HCT) is not well described. Two hundred twenty-nine children with T-ALL in second complete remission (CR2) received an HCT after myeloablative conditioning between 2000 and 2011 and were reported to the Center for International Blood and Marrow Transplant Research. Median age was 10 years (range, 2 to 18). Donor source was umbilical cord blood (26%), matched sibling bone marrow (38%), or unrelated bone marrow/peripheral blood (36%). Acute (grades II to IV) and chronic graft-versus-host disease occurred in, respectively, 35% (95% confidence interval [CI], 27% to 45%) and 26% (95% CI, 20% to 33%) of patients. Transplant-related mortality at day 100 and 3-year relapse rates were 13% (95% CI, 9% to 18%) and 30% (95% CI, 24% to 37%), respectively. Three-year overall survival and disease-free survival rates were 48% (95% CI, 41% to 55%) and 46% (95% CI, 39% to 52%), respectively. In multivariate analysis, patients with bone marrow relapse, with or without concurrent extramedullary relapse before HCT, were most likely to relapse (hazard ratio, 3.94; P =.005) as compared with isolated extramedullary disease. In conclusion, HCT for pediatric T-ALL in CR2 demonstrates reasonable and durable outcomes, and consideration for HCT is warranted. (c) 2015 American Society for Blood and Marrow Transplantation.

Place, publisher, year, edition, pages
2015. Vol. 21, no 12, 2154-2159 p.
Keyword [en]
Pediatric, T-cell ALL, Relapse, Acute lymphoblastic leukemia, Transplantation
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URN: urn:nbn:se:uu:diva-270422DOI: 10.1016/j.bbmt.2015.08.023ISI: 000364981700018PubMedID: 26327632OAI: oai:DiVA.org:uu-270422DiVA: diva2:907619
Available from: 2016-02-29 Created: 2015-12-28 Last updated: 2016-02-29Bibliographically approved

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Olsson, Richard F.
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HaematologyCentrum för klinisk forskning i Sörmland (CKFD)
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