1. Impact of marrow unrelated donor search duration on outcome of children with acute lymphoblastic leukemia in second remission
- Author
-
Evelina Mazzolari, Edoardo Lanino, Adriana Balduzzi, Alberto Bosi, Stefania Galimberti, Francesco Locatelli, P. Di Bartolomeo, Giovanna Giorgiani, Marco Rabusin, M Grazia Valsecchi, Alessandro Busca, Nicoletta Sacchi, Andrea Pession, A. Prete, Teresa Lamparelli, Claudio Favre, Simone Cesaro, Giorgio Dini, William Arcese, Carla Manzitti, Concetta Micalizzi, Dini, G, Valsecchi, M, Micalizzi, C, Busca, A, Balduzzi, A, Arcese, W, Cesaro, S, Prete, A, Rabusin, M, Mazzolari, E, Di Bartolomeo, P, Sacchi, N, Pession, A, Giorgiani, G, Lanino, E, Lamparelli, T, Favre, C, Bosi, A, Manzitti, C, Galimberti, S, and Locatelli, F
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,Adolescent ,medicine.medical_treatment ,unrelated marrow donor ,donor search ,cord blood transplantation ,Precursor Cell Lymphoblastic Leukemia-Lymphoma ,Humans ,Retrospective Studies ,Child ,Recurrence ,Tissue Donors ,Child, Preschool ,Infant ,Registries ,Treatment Outcome ,Antineoplastic Combined Chemotherapy Protocols ,Bone Marrow Transplantation ,Female ,Survival Analysis ,Remission Induction ,pediatric leukemia, stem cell transplant, donor search ,Acute lymphocytic leukemia ,Internal medicine ,stem cell transplant ,medicine ,Preschool ,Childhood Acute Lymphoblastic Leukemia ,Survival analysis ,Transplantation ,Chemotherapy ,business.industry ,Retrospective cohort study ,Hematology ,medicine.disease ,Surgery ,medicine.anatomical_structure ,El Niño ,childhood acute lymphoblastic leukemia ,pediatric leukemia ,Bone marrow ,business ,Settore MED/15 - Malattie del Sangue ,Progressive disease - Abstract
We analyzed the outcome of 167 consecutive children with second CR acute lymphoblastic leukemia ( ALL), for whom an unrelated donor (UD) search was activated between 1989 and 1998 at a median time of 2 months after relapse. A suitable donor was identified for 70 patients at 1 year and 6.5 months before and after 1995 from search activation, respectively; a further leukemia relapse occurred during the search in 94 children at a median of 4 months after search activation, 36 of whom underwent UD ( 14) or other types of transplant ( 22), beyond second CR, while 58 died of progressive disease. Of 73 patients not experiencing a second relapse, 64 underwent UD ( 46) or other types of transplant ( 18), while nine proceeded with chemotherapy, and only four of them survived. The 3-year disease-free survival (DFS) from second CR for the 167 patients is 15.1%, whereas 3-year DFS after transplant for the 60 UD and 40 alternative donor transplanted children is 31.6 and 25.4%, respectively. In conclusion, a further relapse is the main factor adversely affecting outcome of children with second CR ALL. Thus, for these patients, the search should be activated early after relapse and either a UD or an alternative transplant should be performed as early as possible.
- Published
- 2003