Treatment of Relapse After Allogeneic Stem Cell Transplantation in Children and Adolescents with ALL: the Frankfurt Experience

Overview

Journal Bone Marrow Transplant

Specialty General Surgery

Date 2016 Sep 20

PMID 27643863

Citations 9

Authors

A M Willasch

E Salzmann-Manrique

T Krenn

M Duerken

J Faber

J Opper

H Kreyenberg

R Bager

S Huenecke

C Cappel

M Bremm

V Pfirrmann

M Merker

E Ullrich

S Bakhtiar

E Rettinger

A Jarisch

J Soerensen

T E Klingebiel

P Bader

Affiliations

Soon will be listed here.

Abstract

Therapy for post-transplant relapse of paediatric ALL is limited. Standardised curative approaches are not available. We hereby describe our local procedure in this life-threatening situation. A total of 101 ALL patients received their first allogeneic stem cell transplantation (SCT) in our institution. After relapse, our primary therapeutic goal was to cure the patient with high-dose chemotherapy or specific immunotherapy (HDCHT/SIT) followed by a second SCT from a haploidentical donor (transplant approach). If this was not feasible, low-dose chemotherapy and donor lymphocyte infusions (LDCHT+DLI) were offered (non-transplant approach). A total of 23 patients suffered a post-transplant relapse. Eight patients received HDCHT/SIT, followed by haploidentical SCT in 7/8. Ten received LDCHT+DLI. The eight patients treated with a second transplant and the ten treated with the non-transplant approach had a 4-year overall survival of 56% and 40%, respectively (P=0.232). Prerequisites for successful treatment of post-transplant relapse by either a second transplant or experimental non-transplant approaches are good clinical condition and the capacity to achieve haematological remission by the induction treatment element.

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