The impact of second allogeneic hematopoietic stem cell transplantation as salvage therapy for hematologic diseases after a first allogeneic transplantation
Küçük Resim Yok
Tarih
2025
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Pergamon-Elsevier Science Ltd
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Background and objectives: Acute leukemia patients who relapse after the first allogeneic stem-cell transplantation (HSCT1) have a poor prognosis. Second allogeneic hematopoietic stem-cell transplantation (HSCT2) is a therapeutic option for patients with acute myeloid leukemia (AML)/acute lymphoblastic leukemia (ALL) relapsing after HSCT1. Our aim is to evaluate the efficacy of HSCT2 in acute leukemia patients who relapsed after HSCT1. Material and methods: In the current study, we retrospectively analyzed the data of 72 patients who underwent HSCT2. Forty-six patients with AML and 26 patients with ALL were included in the study. Results: Before undergoing HSCT2, 47 % of patients were in complete remission. Median follow-up was 8 (1-109) months. Mortality at last follow-up was 61.1 %, and the median overall survival was 11 months (95 % CI: 1-22.9). Univariate analysis identified that age, Eastern Cooperative Oncology Group (ECOG), Body Mass Index, chimerism, conditioning regimen, CD34+ infused cell count, post-transplant cyclophosphamide usage, disease type, pre transplant hemoglobin-lymphocyte-lactate dehydrogenase-ferritin might be significant factors. After multivariate analysis ECOG (HR: 2.142; 95 % CI: 1.061-4.326; p = 0.034) was the only independent predictor for survival. Conclusion: HSCT2 remains a feasible but high-risk treatment option for patients with relapsed acute leukemia after HSCT1. Our findings confirm that ECOG performance status is a key determinant of survival despite advances in transplantation techniques.
Açıklama
Anahtar Kelimeler
Acute myeloid leukemia, Acute lymphoblastic leukemia, Second hematopoietic stem cell transplantation, Overall survival
Kaynak
Transfusion and Apheresis Science
WoS Q Değeri
Q4
Scopus Q Değeri
Q3
Cilt
64
Sayı
4
