TY - JOUR
T1 - Transplantation Outcomes for Children with Hypodiploid Acute Lymphoblastic Leukemia
AU - Mehta, Parinda A.
AU - Zhang, Mei Jie
AU - Eapen, Mary
AU - He, Wensheng
AU - Seber, Adriana
AU - Gibson, Brenda
AU - Camitta, Bruce M.
AU - Kitko, Carrie L.
AU - Dvorak, Christopher C.
AU - Nemecek, Eneida R.
AU - Frangoul, Haydar A.
AU - Abdel-Azim, Hisham
AU - Kasow, Kimberly A.
AU - Lehmann, Leslie
AU - Gonzalez Vicent, Marta
AU - Diaz Pérez, Miguel A.
AU - Ayas, Mouhab
AU - Qayed, Muna
AU - Carpenter, Paul A.
AU - Jodele, Sonata
AU - Lund, Troy C.
AU - Leung, Wing H.
AU - Davies, Stella M.
N1 - Publisher Copyright:
© 2015 American Society for Blood and Marrow Transplantation.
PY - 2015/7/1
Y1 - 2015/7/1
N2 - Children with hypodiploid acute lymphoblastic leukemia (ALL) have inferior outcomes despite intensive risk-adapted chemotherapy regimens. We describe 78 children with hypodiploid ALL who underwent hematopoietic stem cell transplantation between 1990 and 2010. Thirty-nine (50%) patients had ≤ 43 chromosomes, 12 (15%) had 44 chromosomes, and 27 (35%) had 45 chromosomes. Forty-three (55%) patients underwent transplantation in first remission (CR1) and 35 (45%) underwent transplantation in ≥ second remission (CR2). Twenty-nine patients (37%) received a graft from a related donor and 49 (63%) from an unrelated donor. All patients received a myeloablative conditioning regimen. The 5-year probabilities of leukemia-free survival, overall survival, relapse, and treatment-related mortality for the entire cohort were 51%, 56%, 27%, and 22%, respectively. Multivariate analysis confirmed that mortality risks were higher for patients who underwent transplantation in CR2 (hazard ratio, 2.16; P= .05), with number of chromosomes ≤ 43 (hazard ratio, 2.15; P= .05), and for those who underwent transplantation in the first decade of the study period (hazard ratio, 2.60; P= .01). Similarly, treatment failure risks were higher with number of chromosomes ≤ 43 (hazard ratio, 2.28; P= .04) and the earlier transplantation period (hazard ratio, 2.51; P= .01). Although survival is better with advances in donor selection and supportive care, disease-related risk factors significantly influence transplantation outcomes.
AB - Children with hypodiploid acute lymphoblastic leukemia (ALL) have inferior outcomes despite intensive risk-adapted chemotherapy regimens. We describe 78 children with hypodiploid ALL who underwent hematopoietic stem cell transplantation between 1990 and 2010. Thirty-nine (50%) patients had ≤ 43 chromosomes, 12 (15%) had 44 chromosomes, and 27 (35%) had 45 chromosomes. Forty-three (55%) patients underwent transplantation in first remission (CR1) and 35 (45%) underwent transplantation in ≥ second remission (CR2). Twenty-nine patients (37%) received a graft from a related donor and 49 (63%) from an unrelated donor. All patients received a myeloablative conditioning regimen. The 5-year probabilities of leukemia-free survival, overall survival, relapse, and treatment-related mortality for the entire cohort were 51%, 56%, 27%, and 22%, respectively. Multivariate analysis confirmed that mortality risks were higher for patients who underwent transplantation in CR2 (hazard ratio, 2.16; P= .05), with number of chromosomes ≤ 43 (hazard ratio, 2.15; P= .05), and for those who underwent transplantation in the first decade of the study period (hazard ratio, 2.60; P= .01). Similarly, treatment failure risks were higher with number of chromosomes ≤ 43 (hazard ratio, 2.28; P= .04) and the earlier transplantation period (hazard ratio, 2.51; P= .01). Although survival is better with advances in donor selection and supportive care, disease-related risk factors significantly influence transplantation outcomes.
KW - Hematopoietic stem cell transplantation
KW - Hypodiploid acute lymphoblastic leukemia
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U2 - 10.1016/j.bbmt.2015.04.008
DO - 10.1016/j.bbmt.2015.04.008
M3 - Article
C2 - 25865650
AN - SCOPUS:84930582139
SN - 1083-8791
VL - 21
SP - 1273
EP - 1277
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
IS - 7
ER -