Transplantation Outcomes for Children with Hypodiploid Acute Lymphoblastic Leukemia

Parinda A. Mehta, Mei Jie Zhang, Mary Eapen, Wensheng He, Adriana Seber, Brenda Gibson, Bruce M. Camitta, Carrie L. Kitko, Christopher C. Dvorak, Eneida Nemecek, Haydar A. Frangoul, Hisham Abdel-Azim, Kimberly A. Kasow, Leslie Lehmann, Marta Gonzalez Vicent, Miguel A. Diaz Pérez, Mouhab Ayas, Muna Qayed, Paul A. Carpenter, Sonata JodeleTroy C. Lund, Wing H. Leung, Stella M. Davies

Research output: Contribution to journalArticle

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Abstract

Children with hypodiploid acute lymphoblastic leukemia (ALL) have inferior outcomes despite intensive risk-adapted chemotherapy regimens. We describe 78 children with hypodiploid ALL who underwent hematopoietic stem cell transplantation between 1990 and 2010. Thirty-nine (50%) patients had ≤ 43 chromosomes, 12 (15%) had 44 chromosomes, and 27 (35%) had 45 chromosomes. Forty-three (55%) patients underwent transplantation in first remission (CR1) and 35 (45%) underwent transplantation in ≥ second remission (CR2). Twenty-nine patients (37%) received a graft from a related donor and 49 (63%) from an unrelated donor. All patients received a myeloablative conditioning regimen. The 5-year probabilities of leukemia-free survival, overall survival, relapse, and treatment-related mortality for the entire cohort were 51%, 56%, 27%, and 22%, respectively. Multivariate analysis confirmed that mortality risks were higher for patients who underwent transplantation in CR2 (hazard ratio, 2.16; P= .05), with number of chromosomes ≤ 43 (hazard ratio, 2.15; P= .05), and for those who underwent transplantation in the first decade of the study period (hazard ratio, 2.60; P= .01). Similarly, treatment failure risks were higher with number of chromosomes ≤ 43 (hazard ratio, 2.28; P= .04) and the earlier transplantation period (hazard ratio, 2.51; P= .01). Although survival is better with advances in donor selection and supportive care, disease-related risk factors significantly influence transplantation outcomes.

Original languageEnglish (US)
Pages (from-to)1273-1277
Number of pages5
JournalBiology of Blood and Marrow Transplantation
Volume21
Issue number7
DOIs
StatePublished - Jul 1 2015

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Precursor Cell Lymphoblastic Leukemia-Lymphoma
Transplantation
Chromosomes
Survival
Chromosomes, Human, Pair 15
Donor Selection
Chromosomes, Human, Pair 12
Unrelated Donors
Mortality
Hematopoietic Stem Cell Transplantation
Treatment Failure
Leukemia
Multivariate Analysis
Tissue Donors
Transplants
Recurrence
Drug Therapy

Keywords

  • Hematopoietic stem cell transplantation
  • Hypodiploid acute lymphoblastic leukemia

ASJC Scopus subject areas

  • Transplantation
  • Hematology

Cite this

Mehta, P. A., Zhang, M. J., Eapen, M., He, W., Seber, A., Gibson, B., ... Davies, S. M. (2015). Transplantation Outcomes for Children with Hypodiploid Acute Lymphoblastic Leukemia. Biology of Blood and Marrow Transplantation, 21(7), 1273-1277. https://doi.org/10.1016/j.bbmt.2015.04.008

Transplantation Outcomes for Children with Hypodiploid Acute Lymphoblastic Leukemia. / Mehta, Parinda A.; Zhang, Mei Jie; Eapen, Mary; He, Wensheng; Seber, Adriana; Gibson, Brenda; Camitta, Bruce M.; Kitko, Carrie L.; Dvorak, Christopher C.; Nemecek, Eneida; Frangoul, Haydar A.; Abdel-Azim, Hisham; Kasow, Kimberly A.; Lehmann, Leslie; Gonzalez Vicent, Marta; Diaz Pérez, Miguel A.; Ayas, Mouhab; Qayed, Muna; Carpenter, Paul A.; Jodele, Sonata; Lund, Troy C.; Leung, Wing H.; Davies, Stella M.

In: Biology of Blood and Marrow Transplantation, Vol. 21, No. 7, 01.07.2015, p. 1273-1277.

Research output: Contribution to journalArticle

Mehta, PA, Zhang, MJ, Eapen, M, He, W, Seber, A, Gibson, B, Camitta, BM, Kitko, CL, Dvorak, CC, Nemecek, E, Frangoul, HA, Abdel-Azim, H, Kasow, KA, Lehmann, L, Gonzalez Vicent, M, Diaz Pérez, MA, Ayas, M, Qayed, M, Carpenter, PA, Jodele, S, Lund, TC, Leung, WH & Davies, SM 2015, 'Transplantation Outcomes for Children with Hypodiploid Acute Lymphoblastic Leukemia', Biology of Blood and Marrow Transplantation, vol. 21, no. 7, pp. 1273-1277. https://doi.org/10.1016/j.bbmt.2015.04.008
Mehta, Parinda A. ; Zhang, Mei Jie ; Eapen, Mary ; He, Wensheng ; Seber, Adriana ; Gibson, Brenda ; Camitta, Bruce M. ; Kitko, Carrie L. ; Dvorak, Christopher C. ; Nemecek, Eneida ; Frangoul, Haydar A. ; Abdel-Azim, Hisham ; Kasow, Kimberly A. ; Lehmann, Leslie ; Gonzalez Vicent, Marta ; Diaz Pérez, Miguel A. ; Ayas, Mouhab ; Qayed, Muna ; Carpenter, Paul A. ; Jodele, Sonata ; Lund, Troy C. ; Leung, Wing H. ; Davies, Stella M. / Transplantation Outcomes for Children with Hypodiploid Acute Lymphoblastic Leukemia. In: Biology of Blood and Marrow Transplantation. 2015 ; Vol. 21, No. 7. pp. 1273-1277.
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AU - Mehta, Parinda A.

AU - Zhang, Mei Jie

AU - Eapen, Mary

AU - He, Wensheng

AU - Seber, Adriana

AU - Gibson, Brenda

AU - Camitta, Bruce M.

AU - Kitko, Carrie L.

AU - Dvorak, Christopher C.

AU - Nemecek, Eneida

AU - Frangoul, Haydar A.

AU - Abdel-Azim, Hisham

AU - Kasow, Kimberly A.

AU - Lehmann, Leslie

AU - Gonzalez Vicent, Marta

AU - Diaz Pérez, Miguel A.

AU - Ayas, Mouhab

AU - Qayed, Muna

AU - Carpenter, Paul A.

AU - Jodele, Sonata

AU - Lund, Troy C.

AU - Leung, Wing H.

AU - Davies, Stella M.

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N2 - Children with hypodiploid acute lymphoblastic leukemia (ALL) have inferior outcomes despite intensive risk-adapted chemotherapy regimens. We describe 78 children with hypodiploid ALL who underwent hematopoietic stem cell transplantation between 1990 and 2010. Thirty-nine (50%) patients had ≤ 43 chromosomes, 12 (15%) had 44 chromosomes, and 27 (35%) had 45 chromosomes. Forty-three (55%) patients underwent transplantation in first remission (CR1) and 35 (45%) underwent transplantation in ≥ second remission (CR2). Twenty-nine patients (37%) received a graft from a related donor and 49 (63%) from an unrelated donor. All patients received a myeloablative conditioning regimen. The 5-year probabilities of leukemia-free survival, overall survival, relapse, and treatment-related mortality for the entire cohort were 51%, 56%, 27%, and 22%, respectively. Multivariate analysis confirmed that mortality risks were higher for patients who underwent transplantation in CR2 (hazard ratio, 2.16; P= .05), with number of chromosomes ≤ 43 (hazard ratio, 2.15; P= .05), and for those who underwent transplantation in the first decade of the study period (hazard ratio, 2.60; P= .01). Similarly, treatment failure risks were higher with number of chromosomes ≤ 43 (hazard ratio, 2.28; P= .04) and the earlier transplantation period (hazard ratio, 2.51; P= .01). Although survival is better with advances in donor selection and supportive care, disease-related risk factors significantly influence transplantation outcomes.

AB - Children with hypodiploid acute lymphoblastic leukemia (ALL) have inferior outcomes despite intensive risk-adapted chemotherapy regimens. We describe 78 children with hypodiploid ALL who underwent hematopoietic stem cell transplantation between 1990 and 2010. Thirty-nine (50%) patients had ≤ 43 chromosomes, 12 (15%) had 44 chromosomes, and 27 (35%) had 45 chromosomes. Forty-three (55%) patients underwent transplantation in first remission (CR1) and 35 (45%) underwent transplantation in ≥ second remission (CR2). Twenty-nine patients (37%) received a graft from a related donor and 49 (63%) from an unrelated donor. All patients received a myeloablative conditioning regimen. The 5-year probabilities of leukemia-free survival, overall survival, relapse, and treatment-related mortality for the entire cohort were 51%, 56%, 27%, and 22%, respectively. Multivariate analysis confirmed that mortality risks were higher for patients who underwent transplantation in CR2 (hazard ratio, 2.16; P= .05), with number of chromosomes ≤ 43 (hazard ratio, 2.15; P= .05), and for those who underwent transplantation in the first decade of the study period (hazard ratio, 2.60; P= .01). Similarly, treatment failure risks were higher with number of chromosomes ≤ 43 (hazard ratio, 2.28; P= .04) and the earlier transplantation period (hazard ratio, 2.51; P= .01). Although survival is better with advances in donor selection and supportive care, disease-related risk factors significantly influence transplantation outcomes.

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