Second HLA-identical sibling transplants for leukemia recurrence

M. Mrsic, M. M. Horowitz, K. Atkinson, J. C. Biggs, R. E. Champlin, G. Ehninger, J. L. Gajewski, R. P. Gale, R. H. Herzig, H. G. Prentice, C. Rozman, K. A. Sobocinski, B. Speck, M. M. Bortin

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Abstract

We analysed data from 114 recipients of HLA-identical sibling transplants who relapsed and received a second transplant between 1978 and 1989. Twenty-nine patients had acute lymphoblastic leukemia, 46 acute myeloid leukemia and 39 chronic myelogenous leukemia. Median (range) interval between first and second transplants was 15 (1-80) months. Following the second transplant, graft failure occurred in 2%, acute graftversus-host disease (GVHD) in 27% and chronic GVHD in 21% of patients at risk. Risks of interstitial pneumonia and hepatic veno-occlusive disease were higher after the second than the first transplant. Two year probabilities (95% confidence interval) of treatment-related mortality, relapse and leukemia-free survival were 41% (30-53%), 65% (53-75%) and 21% (14-30%), respectively. Leukemia-free survival was 7% (2-19%) among patients relapsing less than 6 months after their first transplant, with high rates of both relapse, 77% (49-92%), and treatment-related mortality 69% (46-85%). In contrast, leukemia-free survival was 28% (19-41%) in those relapsing more than 6 months after the first transplant; in this group the probability of relapse was 59% (45-72%) and treatment-related mortality 30% (20-43%). Factors correlated with better outcome included a diagnosis of chronic myelogenous leukemia, relapse more than 6 months after the first transplant, acute leukemia in remission prior to the second transplant and good performance status.

Original languageEnglish (US)
Pages (from-to)269-275
Number of pages7
JournalBone Marrow Transplantation
Volume9
Issue number4
StatePublished - 1992
Externally publishedYes

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Siblings
Leukemia
Transplants
Recurrence
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Survival
Mortality
Hepatic Veno-Occlusive Disease
Interstitial Lung Diseases
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Acute Myeloid Leukemia
Therapeutics
Confidence Intervals

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Mrsic, M., Horowitz, M. M., Atkinson, K., Biggs, J. C., Champlin, R. E., Ehninger, G., ... Bortin, M. M. (1992). Second HLA-identical sibling transplants for leukemia recurrence. Bone Marrow Transplantation, 9(4), 269-275.

Second HLA-identical sibling transplants for leukemia recurrence. / Mrsic, M.; Horowitz, M. M.; Atkinson, K.; Biggs, J. C.; Champlin, R. E.; Ehninger, G.; Gajewski, J. L.; Gale, R. P.; Herzig, R. H.; Prentice, H. G.; Rozman, C.; Sobocinski, K. A.; Speck, B.; Bortin, M. M.

In: Bone Marrow Transplantation, Vol. 9, No. 4, 1992, p. 269-275.

Research output: Contribution to journalArticle

Mrsic, M, Horowitz, MM, Atkinson, K, Biggs, JC, Champlin, RE, Ehninger, G, Gajewski, JL, Gale, RP, Herzig, RH, Prentice, HG, Rozman, C, Sobocinski, KA, Speck, B & Bortin, MM 1992, 'Second HLA-identical sibling transplants for leukemia recurrence', Bone Marrow Transplantation, vol. 9, no. 4, pp. 269-275.
Mrsic M, Horowitz MM, Atkinson K, Biggs JC, Champlin RE, Ehninger G et al. Second HLA-identical sibling transplants for leukemia recurrence. Bone Marrow Transplantation. 1992;9(4):269-275.
Mrsic, M. ; Horowitz, M. M. ; Atkinson, K. ; Biggs, J. C. ; Champlin, R. E. ; Ehninger, G. ; Gajewski, J. L. ; Gale, R. P. ; Herzig, R. H. ; Prentice, H. G. ; Rozman, C. ; Sobocinski, K. A. ; Speck, B. ; Bortin, M. M. / Second HLA-identical sibling transplants for leukemia recurrence. In: Bone Marrow Transplantation. 1992 ; Vol. 9, No. 4. pp. 269-275.
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abstract = "We analysed data from 114 recipients of HLA-identical sibling transplants who relapsed and received a second transplant between 1978 and 1989. Twenty-nine patients had acute lymphoblastic leukemia, 46 acute myeloid leukemia and 39 chronic myelogenous leukemia. Median (range) interval between first and second transplants was 15 (1-80) months. Following the second transplant, graft failure occurred in 2{\%}, acute graftversus-host disease (GVHD) in 27{\%} and chronic GVHD in 21{\%} of patients at risk. Risks of interstitial pneumonia and hepatic veno-occlusive disease were higher after the second than the first transplant. Two year probabilities (95{\%} confidence interval) of treatment-related mortality, relapse and leukemia-free survival were 41{\%} (30-53{\%}), 65{\%} (53-75{\%}) and 21{\%} (14-30{\%}), respectively. Leukemia-free survival was 7{\%} (2-19{\%}) among patients relapsing less than 6 months after their first transplant, with high rates of both relapse, 77{\%} (49-92{\%}), and treatment-related mortality 69{\%} (46-85{\%}). In contrast, leukemia-free survival was 28{\%} (19-41{\%}) in those relapsing more than 6 months after the first transplant; in this group the probability of relapse was 59{\%} (45-72{\%}) and treatment-related mortality 30{\%} (20-43{\%}). Factors correlated with better outcome included a diagnosis of chronic myelogenous leukemia, relapse more than 6 months after the first transplant, acute leukemia in remission prior to the second transplant and good performance status.",
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AU - Mrsic, M.

AU - Horowitz, M. M.

AU - Atkinson, K.

AU - Biggs, J. C.

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AU - Ehninger, G.

AU - Gajewski, J. L.

AU - Gale, R. P.

AU - Herzig, R. H.

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AU - Speck, B.

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AB - We analysed data from 114 recipients of HLA-identical sibling transplants who relapsed and received a second transplant between 1978 and 1989. Twenty-nine patients had acute lymphoblastic leukemia, 46 acute myeloid leukemia and 39 chronic myelogenous leukemia. Median (range) interval between first and second transplants was 15 (1-80) months. Following the second transplant, graft failure occurred in 2%, acute graftversus-host disease (GVHD) in 27% and chronic GVHD in 21% of patients at risk. Risks of interstitial pneumonia and hepatic veno-occlusive disease were higher after the second than the first transplant. Two year probabilities (95% confidence interval) of treatment-related mortality, relapse and leukemia-free survival were 41% (30-53%), 65% (53-75%) and 21% (14-30%), respectively. Leukemia-free survival was 7% (2-19%) among patients relapsing less than 6 months after their first transplant, with high rates of both relapse, 77% (49-92%), and treatment-related mortality 69% (46-85%). In contrast, leukemia-free survival was 28% (19-41%) in those relapsing more than 6 months after the first transplant; in this group the probability of relapse was 59% (45-72%) and treatment-related mortality 30% (20-43%). Factors correlated with better outcome included a diagnosis of chronic myelogenous leukemia, relapse more than 6 months after the first transplant, acute leukemia in remission prior to the second transplant and good performance status.

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