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

Michael J. Burke, Michael R. Verneris, Jennifer Le-Rademacher, Wensheng He, Hisham Abdel-Azim, Allistair A. Abraham, Jeffery J. Auletta, Mouhab Ayas, Valerie I. Brown, Mitchell S. Cairo, Ka Wah Chan, Miguel A. Diaz Perez, Christopher C. Dvorak, R. Maarten Egeler, Lamis Eldjerou, Haydar Frangoul, Gregory M.T. Guilcher, Robert J. Hayashi, Ahmed Ibrahim, Kimberly A. KasowWing H. Leung, Richard F. Olsson, Michael A. Pulsipher, Niketa Shah, Nirali N. Shah, Elizabeth Thiel, Julie An Talano, Carrie L. Kitko

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)2154-2159
Number of pages6
JournalBiology of Blood and Marrow Transplantation
Volume21
Issue number12
DOIs
StatePublished - Dec 1 2015
Externally publishedYes

Fingerprint

Precursor T-Cell Lymphoblastic Leukemia-Lymphoma
Cell Transplantation
Bone Marrow
Confidence Intervals
Transplants
Research
Recurrence
Survival
Graft vs Host Disease
Fetal Blood
Disease-Free Survival
Siblings
Multivariate Analysis
Survival Rate
Tissue Donors
Pediatrics
Drug Therapy
Mortality

Keywords

  • Acute lymphoblastic leukemia
  • Pediatric
  • Relapse
  • T-cell ALL
  • Transplantation

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

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. / Burke, Michael J.; Verneris, Michael R.; Le-Rademacher, Jennifer; He, Wensheng; Abdel-Azim, Hisham; Abraham, Allistair A.; Auletta, Jeffery J.; Ayas, Mouhab; Brown, Valerie I.; Cairo, Mitchell S.; Chan, Ka Wah; Diaz Perez, Miguel A.; Dvorak, Christopher C.; Egeler, R. Maarten; Eldjerou, Lamis; Frangoul, Haydar; Guilcher, Gregory M.T.; Hayashi, Robert J.; Ibrahim, Ahmed; Kasow, Kimberly A.; Leung, Wing H.; Olsson, Richard F.; Pulsipher, Michael A.; Shah, Niketa; Shah, Nirali N.; Thiel, Elizabeth; Talano, Julie An; Kitko, Carrie L.

In: Biology of Blood and Marrow Transplantation, Vol. 21, No. 12, 01.12.2015, p. 2154-2159.

Research output: Contribution to journalArticle

Burke, MJ, Verneris, MR, Le-Rademacher, J, He, W, Abdel-Azim, H, Abraham, AA, Auletta, JJ, Ayas, M, Brown, VI, Cairo, MS, Chan, KW, Diaz Perez, MA, Dvorak, CC, Egeler, RM, Eldjerou, L, Frangoul, H, Guilcher, GMT, Hayashi, RJ, Ibrahim, A, Kasow, KA, Leung, WH, Olsson, RF, Pulsipher, MA, Shah, N, Shah, NN, Thiel, E, Talano, JA & Kitko, CL 2015, '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', Biology of Blood and Marrow Transplantation, vol. 21, no. 12, pp. 2154-2159. https://doi.org/10.1016/j.bbmt.2015.08.023
Burke, Michael J. ; Verneris, Michael R. ; Le-Rademacher, Jennifer ; He, Wensheng ; Abdel-Azim, Hisham ; Abraham, Allistair A. ; Auletta, Jeffery J. ; Ayas, Mouhab ; Brown, Valerie I. ; Cairo, Mitchell S. ; Chan, Ka Wah ; Diaz Perez, Miguel A. ; Dvorak, Christopher C. ; Egeler, R. Maarten ; Eldjerou, Lamis ; Frangoul, Haydar ; Guilcher, Gregory M.T. ; Hayashi, Robert J. ; Ibrahim, Ahmed ; Kasow, Kimberly A. ; Leung, Wing H. ; Olsson, Richard F. ; Pulsipher, Michael A. ; Shah, Niketa ; Shah, Nirali N. ; Thiel, Elizabeth ; Talano, Julie An ; Kitko, Carrie L. / 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. In: Biology of Blood and Marrow Transplantation. 2015 ; Vol. 21, No. 12. pp. 2154-2159.
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abstract = "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.",
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AU - Le-Rademacher, Jennifer

AU - He, Wensheng

AU - Abdel-Azim, Hisham

AU - Abraham, Allistair A.

AU - Auletta, Jeffery J.

AU - Ayas, Mouhab

AU - Brown, Valerie I.

AU - Cairo, Mitchell S.

AU - Chan, Ka Wah

AU - Diaz Perez, Miguel A.

AU - Dvorak, Christopher C.

AU - Egeler, R. Maarten

AU - Eldjerou, Lamis

AU - Frangoul, Haydar

AU - Guilcher, Gregory M.T.

AU - Hayashi, Robert J.

AU - Ibrahim, Ahmed

AU - Kasow, Kimberly A.

AU - Leung, Wing H.

AU - Olsson, Richard F.

AU - Pulsipher, Michael A.

AU - Shah, Niketa

AU - Shah, Nirali N.

AU - Thiel, Elizabeth

AU - Talano, Julie An

AU - Kitko, Carrie L.

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N2 - 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.

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