Second hematopoietic SCT for leukemia relapsing after myeloablative T cell-depleted transplants does not prolong survival

作者：McIver Z A^*; Yin F; Hughes T; Battiwalla M; Ito S; Koklanaris E; Haggerty J; Barrett A John

来源：Bone Marrow Transplantation, 2013, 48(9): 1192-1197.

DOI：10.1038/bmt.2013.39

• second SCT
• leukemia
• relapse
• T-depleted
• survival

Patients with leukemia relapsing after allogeneic hematopoietic SCT have a dismal prognosis. A second SCT offers a further opportunity for cure, but has a high rate of treatment failure. To determine the utility of this option, we analyzed 59 consecutive patients relapsing after a myeloablative HLA-matched sibling T cell-depleted (TCD) SCT. Twenty-five patients (13 relapsing within 6 months and 12 relapsing between 6 and 170 months after the first SCT) received a T-replete second SCT. Thirty-eight patients relapsing early had a shorter survival than the 21 patients relapsing later (median 96 vs 298 days, P = 0.0002). In patients relapsing early, the second SCT did not improve OS compared with patients receiving non-SCT treatments (median survival 109 vs 80 days, P = 0.41). In patients relapsing late, despite an early trend in favor of second SCT, survival was comparable for patients receiving a second SCT compared with non retransplanted patients (median survival 363.5 vs 162 days, P = 0.49). Disappointingly, our results do not demonstrate an important survival benefit for a second T-replete allogeneic SCT to treat relapse following a TCD SCT.

• 出版日期2013-9
• 单位NIH