Outcomes of pediatric patients who relapse after first HCT for acute leukemia or MDS

Sharma, Akshay; Liu, Ying; Huang, Sujuan; Talleur, Aimee C; Suliman, Ali; Qudeimat, Amr; Srinivasan, Ashok; Mamcarz, Ewelina; Madden, Renee; Cheng, Cheng

doi:10.1038/s41409-021-01267-0

Cited by 10 publications

(8 citation statements)

References 33 publications

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“…This is related to failure to achieve disease remission after post‐transplant relapse or due to reasons such as infection and bleeding. Numerous previous studies report similar overall outcomes in patients who experience relapse later after the first alloHSCT and are in remission at the time of the second alloHSCT 19,20 …”

Section: Discussionmentioning

confidence: 78%

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The outcome of relapsed childhood acute lymphoblastic leukemia after allogeneic hematopoietic stem‐cell transplantations: A single‐center experience

Aygüneş,

Karagün,

Şaşmaz

et al. 2024

Clinical Transplantation

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In children with high‐risk childhood acute leukemia who undergo allogeneic hematopoietic stem‐cell transplantation (allo‐HSCT), relapse is still the leading cause of treatment failure. The prognosis is poor, yet prospective studies have only limited data on risk factors and outcomes. We aimed to understand the outcomes and prognostic factors for patients with acute lymphoblastic leukemia (ALL) who relapsed following allo‐HSCT. We analyzed retrospectively 46 children with childhood acute lymphoblastic leukemia who had relapsed after receiving their first alloHSCT. All these patients received salvage chemotherapy which consisted of fludarabine, cytarabine, and idarubicin before performing a second alloHSCT. The median follow‐up of the 46 patients after the first transplantation was 366 days. The median time from first allo‐HSCT to relapse was 278.4 ± 238.4 days. Forty‐six patients received salvage chemotherapy before the second alloHSCT, and CR was achieved in 32 of 46 patients. However, only 17 (37%) of 46 patients received a second allo‐HSCT, and 15 of 46 patients died from disease progression, infections, and bleeding. Twelve patients are still alive after the second allo‐HSCT. Two‐year overall survival (OS) was 38.9%. Local therapy was given to 10 (21.8%) patients, either as part of systemic therapy or alone. In multivariate analyses, the time of relapse and curative salvage therapy with a second allo‐HSCT were identified as significant prognostic factors for OS. Children with leukemia who had relapsed after the first allo‐HSCT received salvage chemotherapy. Our statistical analysis showed that the second HSCT could be beneficial for outcomes if patients relapsed beyond 180 days of the first allo‐HSCT.

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Section: Discussionmentioning

confidence: 78%

“…Numerous previous studies report similar overall outcomes in patients who experience relapse later after the first alloHSCT and are in remission at the time of the second alloHSCT. 19,20 When relapse types were evaluated in our study, we were able to determine that there was no difference in terms of treatment results…”

Section: Discussionmentioning

confidence: 94%

The outcome of relapsed childhood acute lymphoblastic leukemia after allogeneic hematopoietic stem‐cell transplantations: A single‐center experience

Aygüneş,

Karagün,

Şaşmaz

et al. 2024

Clinical Transplantation

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“…However, such transplants are associated with high rates of morbidity and mortality, especially for patients with relapsed or refractory leukemia and those who have failed a prior transplant. 6,7 Most research on the psychosocial impact of HCT donation has focused on unrelated and sibling donors. [8][9][10][11][12] To date, only a single study examining the psychological impact of haploidentical donation for parents has been reported.…”

Section: Introductionmentioning

confidence: 99%

“…For patients without an acceptable matched donor, haploidentical transplantation may be their only chance for a cure. However, such transplants are associated with high rates of morbidity and mortality, especially for patients with relapsed or refractory leukemia and those who have failed a prior transplant 6,7 …”

Section: Introductionmentioning

confidence: 99%

“Giving the gift of life twice”: Understanding the lived experiences of parent donors and nondonors in pediatric haploidentical hematopoietic cell transplantation

Schaefer

Aguilera

Parris

et al. 2021

Pediatric Blood & Cancer

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This article describes a retrospective, qualitative study exploring parental perceptions of the pediatric haploidentical hematopoietic cell donation process and the impact of being a donor (or nondonor) on parents' adjustment. Results illustrate satisfaction with information, limited choice, preparation for donation, perceptions of donation/infusion, benefit finding, and the psychological impact of transplantation.

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mentioning

confidence: 99%

“Giving the gift of life twice”: Understanding the lived experiences of parent donors and non-donors in pediatric haploidentical hematopoietic cell transplantation

Schaefer

Aguilera

Parris

et al. 2021

Preprint

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Background: The use of parental donors in pediatric haploidentical hematopoietic cell transplantation is increasing, but research on the psychosocial impact of parental donation is currently limited. We conducted a retrospective, qualitative study to explore parental perceptions of the donation process and the impact of being a donor (or non-donor) on parents’ adjustment and coping with their child’s transplant experience. Methods: Parents/caregivers of children who underwent transplantation with a parental donor or a matched unrelated donor (N = 136) participated in interviews and completed an open-ended questionnaire. Both bereaved parents and parents of survivors were surveyed. Results: Six themes were identified in the data: level of understanding and satisfaction; perception of choice; preparation for donation; perceptions of donation and infusion; benefit-finding; and psychological impact of transplantation. Most parents were satisfied with the information they received and reported a good understanding of transplantation and donation procedures. Parents were divided on perspectives of choice, but their responses reflect that the necessity of saving their child’s life does not allow for choice. They described considerable effort to prepare for transplantation, physically, emotionally, and logistically. Parents acknowledged the psychological impact while identifying positive outcomes that resulted from their child’s transplant journey. Conclusions: Results highlight the unique experiences of parental donors and non-donors from the anticipation phase to the completion of their child’s transplant. Additionally, findings inform supportive care guidance by highlighting the need to assess parental donors’ emotional functioning, provide support post-donation, and conduct bereavement follow-up.

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Outcomes of pediatric patients who relapse after first HCT for acute leukemia or MDS

Cited by 10 publications

References 33 publications

The outcome of relapsed childhood acute lymphoblastic leukemia after allogeneic hematopoietic stem‐cell transplantations: A single‐center experience

The outcome of relapsed childhood acute lymphoblastic leukemia after allogeneic hematopoietic stem‐cell transplantations: A single‐center experience

“Giving the gift of life twice”: Understanding the lived experiences of parent donors and nondonors in pediatric haploidentical hematopoietic cell transplantation

“Giving the gift of life twice”: Understanding the lived experiences of parent donors and non-donors in pediatric haploidentical hematopoietic cell transplantation

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