Outcome after failure of allogeneic hematopoietic stem cell transplantation in children with acute leukemia: a study by the société Francophone de greffe de moelle et de thérapie cellulaire (SFGM-TC)

Roux, Clémence; Tifratene, Karim; Socié, Gérard; Garrigue, Claire; Bertrand, Yves; Rialland, Fanny; Jubert, Charlotte; Pochon, Cécile; Paillard, Catherine; Sîrvent, Anne; Nelken, Brigitte; Vannier, Jean‐Pierre; Freyçon, Claire; Béguin, Yves; Raus, Nicole; Yakoub-Agha, Ibrahim; Mohty, Mohamad; Dalle, J-H; Michel, G; Pradier, C; Latour, Régis Peffault de; Rohrlich, P-S

doi:10.1038/bmt.2016.360

Cited by 27 publications

(34 citation statements)

References 26 publications

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“…In accordance with previously published case series and registry analysis in adults and children, our data indicate that length of remission after first transplantation is probably the most important outcome predictor for relapse after first allo‐SCT (Michallet et al , ; Bosi et al , ; Eapen et al , ; Kato et al , ; Bajwa et al , ; Naik et al , ; Menon et al , ; Roux et al , ).…”

Section: Discussionsupporting

confidence: 91%

“…Second transplantation has been shown to successfully sustain remission in 20‐35% of patients in several series in adults (Michallet et al , ; Bosi et al , ; Eapen et al , ) and up to 43·9% in children (Menon et al , ; Roux et al , ). Our data show that the 3‐year EFS was 33·6% in children undergoing salvage therapy with second SCT.…”

Section: Discussionmentioning

confidence: 99%

“…Intensive chemotherapy can induce remission in some adult patients who relapse after first allo‐SCT, but remission durations are typically short, and most patients die of uncontrolled leukaemia, infectious complications and/or graft‐versus‐host disease (GvHD) (Michallet et al , ; Bosi et al , ; Eapen et al , ). Thus far, prognosis is generally considered dismal in children relapsing after allo‐SCT but data on outcome and prognostic factors are still scarce and are primarily derived from heterogeneous case series or registry analyses comprising different leukaemia entities and highly variable primary transplant approaches (Kato et al , ; Bajwa et al , ; Naik et al , ; Menon et al , ; Roux et al , ).…”

mentioning

confidence: 99%

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Outcome of relapse after allogeneic HSCT in children with ALL enrolled in the ALL‐SCT 2003/2007 trial

et al. 2017

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SummaryRelapse remains the major cause of treatment failure in children with highrisk acute lymphoblastic leukaemia (ALL) undergoing allogeneic haematopoietic stem-cell transplantation (allo-SCT). Prognosis is considered dismal but data on risk factors and outcome are lacking from prospective studies. We analysed 242 children with recurrence of ALL after first allo-SCT enrolled in the Berlin-Frankfurt-Munster (BFM) ALL-SCT-BFM 2003 and ALL-SCT-BFM international 2007 studies. Median time from allo-SCT to relapse was 7Á7 months; median follow-up from relapse after allo-SCT until last follow-up was 3Á4 years. The 3-year event-free survival (EFS) was 15% and overall survival (OS) was 20%. The main cause of death was disease progression or relapse (86Á5%). The majority of children (48%) received salvage therapy without second allo-SCT, 26% of the children underwent a second allo-SCT and 25% received palliative treatment only. In multivariate analyses, age, site of relapse, time to relapse and type of salvage therapy were identified as significant prognostic factors for OS and EFS, whereas factors associated with first SCT were not statistically significant. Combined approaches incorporating novel immunotherapeutic treatment options and second allo-SCT hold promise to improve outcome in children with post allo-SCT relapse.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Outcome of relapse after allogeneic HSCT in children with ALL enrolled in the ALL‐SCT 2003/2007 trial

et al. 2017

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“…Post‐transplant leukemic relapse remains the most common cause of treatment failure, occurring in approximately 30%‐50% of children . Fewer than 20% of children who relapse after alloHCT achieve long‐term disease control . Effective strategies to minimize the risk of post‐transplant leukemic relapse are a priority.…”

Section: Introductionmentioning

confidence: 99%

Low‐dose azacitidine for relapse prevention after allogeneic hematopoietic cell transplantation in children with myeloid malignancies

Oshrine

Shyr

Hale

et al. 2019

Pediatric Transplantation

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Background The prognosis of children who relapse after allogeneic hematopoietic cell transplant (alloHCT) for myeloid malignancies remains poor. Procedure To describe the safety and feasibility of post‐transplant azacitidine for relapse prevention, we retrospectively reviewed the charts of 18 children undergoing alloHCT for myeloid malignancies. Results There were 15 evaluable patients since three patients did not receive planned azacitidine due to early relapse or TRM. Azacitidine (32 mg/m2/dose for 5 days, in 28‐day cycles as tolerated up to 1 year post‐transplant) was started at a median of 66 days post‐transplant (range 42‐118). Two‐thirds (10/15) of patients received eight or more cycles. Five patients stopped therapy early, only one attributable to toxicity. Mild myelosuppression was the most common reason for cycle delays. Dose modifications were made in three patients. There were three relapses, two of which occurred in patients in CR2 and one in CR1, with a median follow‐up of 20 months (range 12.5‐28), and no TRM in patients who received azacitidine. Conclusions Post‐transplant azacitidine in children is safe and feasible, with most patients successfully receiving all planned cycles. Despite the limitations of a small cohort, low relapse incidence suggests a potential benefit in disease control that warrants further investigation.

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“…After allogeneic hematopoietic stem cell transplantation (HSCT), relapse is a major cause of treatment failure for children with acute myeloid leukemia (AML) . Thus, the establishment of effective novel strategies to prevent relapse is a pressing issue.…”

Section: Introductionmentioning

confidence: 99%

Low‐dose azacitidine maintenance therapy after allogeneic stem cell transplantation for high‐risk pediatric acute myeloid leukemia

Tamura

Ishida

Saito

et al. 2018

Pediatric Blood & Cancer

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The dismal prognosis of pediatric acute myeloid leukemia (AML) relapsing after hematopoietic stem cell transplantation (HSCT) requires exploration of novel strategies to prevent relapse. Azacitidine (AZA) maintenance therapy could potentially reduce the recurrence rate post HSCT. Here, we presents the cases of three children with high-risk AML post HSCT who were treated with low-dose AZA maintenance therapy, demonstrating the feasibility of this therapy. Currently, all three are in complete remission for 13-41 months despite their high-risk characteristics. Our encouraging data warrant larger prospective studies to assess the efficacy and safety of low-dose AZA maintenance therapy post HSCT for pediatric patients with high-risk AML.

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Outcome after failure of allogeneic hematopoietic stem cell transplantation in children with acute leukemia: a study by the société Francophone de greffe de moelle et de thérapie cellulaire (SFGM-TC)

Cited by 27 publications

References 26 publications

Outcome of relapse after allogeneic HSCT in children with ALL enrolled in the ALL‐SCT 2003/2007 trial

Outcome of relapse after allogeneic HSCT in children with ALL enrolled in the ALL‐SCT 2003/2007 trial

Low‐dose azacitidine for relapse prevention after allogeneic hematopoietic cell transplantation in children with myeloid malignancies

Low‐dose azacitidine maintenance therapy after allogeneic stem cell transplantation for high‐risk pediatric acute myeloid leukemia

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