All content on this site is intended for healthcare professionals only. By acknowledging this message and accessing the information on this website you are confirming that you are a Healthcare Professional. If you are a patient or carer, please visit Know AML.

  TRANSLATE

The aml Hub website uses a third-party service provided by Google that dynamically translates web content. Translations are machine generated, so may not be an exact or complete translation, and the aml Hub cannot guarantee the accuracy of translated content. The aml and its employees will not be liable for any direct, indirect, or consequential damages (even if foreseeable) resulting from use of the Google Translate feature. For further support with Google Translate, visit Google Translate Help.

The AML Hub is an independent medical education platform, sponsored by Astellas, Daiichi Sankyo, Johnson & Johnson, Kura Oncology and Syndax, and has been supported through educational grants from Bristol Myers Squibb and the Hippocrate Conference Institute, an association of the Servier Group. The funders are allowed no direct influence on our content. The levels of sponsorship listed are reflective of the amount of funding given. View funders.

Now you can support HCPs in making informed decisions for their patients

Your contribution helps us continuously deliver expertly curated content to HCPs worldwide. You will also have the opportunity to make a content suggestion for consideration and receive updates on the impact contributions are making to our content.

Find out more

EBMT 2018 | Second allogeneic HCT improves survival in children with relapsed AML after first transplantation

By Anna Bartus

Share:

Mar 27, 2018


On Tuesday 20 March 2018, at the 44th Annual Meeting of the European Society for Blood and Marrow Transplantation (EBMT), Lisbon, Portugal, Martin Sauer from Hannover Medical School, Pediatric Hematology and Oncology, Hannover, Germany, on behalf of his colleagues presented data of their retrospective analysis investigating the outcomes of children with relapsed acute myeloid leukemia (AML) after first allogeneic hematopoietic stem cell transplantation (allo-HCT) or second HCT.

In total, 336 children (median age = 8.6 years [range, 0.4-26.0]) experiencing relapse after first allo-HCT between 2005–present were enrolled and analyzed in this study. Primary endpoints of the study included overall survival (OS) and risk factor identification.

Key findings:

  • 4-year OS and event-free survival (EFS) in all children were 14% (standard error, SE = 0.02) and 2% (SE = 0.01) respectively
  • 4-year OS in children relapsing < 6 months or ≥ 6 months after first HCT: 7% vs 29% , P < 0.0001
  • 4-year OS in children receiving PBSC/Cord graft and children receiving BM graft: 23% (SE = 0.06) vs 49% (SE = 0.09), P = 0.036

Second allo-HCT was performed in 123(36.6%) children. Reasons for not performing a second HCT included disease progression and failure to achieve another remission (55%), other reasons such as parental decision and palliation (33%) and poor performance status (12%).

  • 4-year OS in patients with (n = 123) or without (n = 213) second HCT: 32% vs 3%, P < 0.0001
  • Causes of death after second HCT:
    • Underlying disease (relapse, progression, or persistence): 65%
    • HCT related cause: 22%
    • Other (infection, multi-organ failure, hemorrhage): 14%

Martin Sauer concluded his talk by stating that survival for children with AML experiencing relapse after first transplantation is very unlikely without undergoing a second HCT. Moreover, relapse after first HCT is an evocative risk factor. Also, children receiving HLA-identical sibling bone marrow graft have a higher chance of survival.

References