How risky is a second allogeneic stem cell transplantation?

Abstract: There is no consensus on second allogeneic stem cell transplantation (alloSCT) indications in patients with hematologic malignancies relapsing after a first alloSCT. In historic publications, a very high non-relapse mortality (NRM) has been described, arguing against performing a second alloSCT. We analysed the outcome of 3356 second alloSCTs performed 2011–21 following a hematologic malignancy relapse. Outcomes at two years after second alloSCT were: NRM 22%, relapse incidence 50%, overall survival 38%, and progression-free survival 28%. Key risk factors for increased NRM were: older age, low performance score, high disease-risk-index, early relapse after the first alloSCT, unrelated/haploidentical donor, and GVHD before second alloSCT. Any type of GVHD after first alloSCT was also important risk factor for acute GVHD and chronic GVHD after second alloSCT. There was a preferential use of a different donor (80%) at second alloSCT from first alloSCT. However, in multivariate analysis, the use of the same alloSCT donor for second alloSCT vs. a different donor was not associated with any of the survival or GVHD endpoints. We show considerably improved outcome as compared to historic reports. These current data support a wider use of second alloSCT and provide risk factors for NRM that need to be considered

Angaben zum Objekt

• Standort: Deutsche Nationalbibliothek Frankfurt am Main
• Umfang: Online-Ressource
• Sprache: Englisch
• Anmerkungen: Leukemia. - 38, 8 (2024) , 1799-1807, ISSN: 1476-5551

Beteiligte, Orts- und Zeitangaben

• Ereignis: Veröffentlichung
• (wo): Freiburg
• (wer): Universität
• (wann): 2024
• Urheber: Penack, Olaf ; Abouqateb, Mouad ; Peczynski, Christophe ; Boreland, William ; Kröger, Nicolaus ; Zeiser, Robert ; Ciceri, Fabio ; Schroeder, Thomas ; Dreger, Peter ; Passweg, Jakob R. ; Schetelig, Johannes ; Stelljes, Matthias ; Blau, Igor-Wolfgang ; Franke, Georg-Nikolaus ; Riesner, Katarina ; Schoemans, Helene ; Moiseev, Ivan ; Peric, Zinaida

Weitere Informationen

• DOI: 10.1038/s41375-024-02318-3
• URN: urn:nbn:de:bsz:25-freidok-2517005
• Rechteinformation: Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
• Letzte Aktualisierung: 25.03.2025, 13:50 MEZ