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 R. 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

13 Scopus citations

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

Keywords

  • Hematopoietic stem cell transplantation
  • Hypodiploid acute lymphoblastic leukemia

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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    Mehta, P. A., Zhang, M. J., Eapen, M., He, W., Seber, A., Gibson, B., Camitta, B. M., Kitko, C. L., Dvorak, C. C., Nemecek, E. R., Frangoul, H. A., Abdel-Azim, H., Kasow, K. A., Lehmann, L., Gonzalez Vicent, M., Diaz Pérez, M. A., Ayas, M., Qayed, M., Carpenter, P. A., ... 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