Outcome of 93 patients with relapse or progression following allogeneic hematopoietic cell transplantation

Saiko Kurosawa, Takahiro Fukuda, Kinuko Tajima, Bungo Saito, Shigeo Fuji, Hiroki Yokoyama, Sung Won Kim, Shin Ichiro Mori, Ryuji Tanosaki, Yuji Heike, Yoichi Takaue

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18 Citations (Scopus)


Relapse/progression after allogeneic hematopoietic cell transplantation (allo-HCT) remains the major cause of treatment failure. In this study, the subsequent clinical outcome was overviewed in 292 patients with leukemia/ myelodysplastic syndrome who received allo-HCT. Among them, 93 (32%) showed relapse/progression. Cohort 1 was chosen to receive no interventions with curative intent (n 5 25). Cohort 2 received reinduction chemotherapy and/or donor lymphocyte infusion (n 5 48), and Cohort 3 underwent a second allo-HCT (n 5 20). Sixty-three patients received reinduction chemotherapy, and 27 (43%) achieved subsequent complete remission (CR). The incidence of nonrelapse mortality (NRM) was similar among the three cohorts (4, 15, and 5%). The 1-year overall survival (OS) after relapse was significantly better in patients with a second HCT (58%) than in others (14%, Cohorts 1 and 2; P < .001). However, the 2-year OS did not differ between the two groups, which suggests that it is difficult to maintain CR after the second HCT. Multivariate analysis showed that reinduction chemotherapy, CR after intervention, second HCT, and longer time to post-transplant relapse were associated with improved survival. In conclusion, for patients with relapse after allo-HCT, successful reinduction chemotherapy and a second HCT may be effective for prolonging survival without excessive NRM. However, effective measures to prevent disease progression after a second HCT clearly need to be developed.

Original languageEnglish
Pages (from-to)815-820
Number of pages6
JournalAmerican journal of hematology
Issue number12
Publication statusPublished - 2009 Dec
Externally publishedYes

ASJC Scopus subject areas

  • Hematology


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