PMID- 19660721
OWN - NLM
STAT- MEDLINE
DCOM- 20091102
LR  - 20211020
IS  - 1523-6536 (Electronic)
IS  - 1083-8791 (Print)
IS  - 1083-8791 (Linking)
VI  - 15
IP  - 9
DP  - 2009 Sep
TI  - Hematopoietic cell transplantation for children with acute lymphoblastic leukemia 
      in second complete remission: similar outcomes in recipients of unrelated marrow 
      and umbilical cord blood versus marrow from HLA matched sibling donors.
PG  - 1086-93
LID - 10.1016/j.bbmt.2009.05.005 [doi]
AB  - Transplant decisions for children with acute lymphoblastic leukemia (ALL) in 
      second complete remission (CR2) are often based on the type of available donor. 
      In many cases, allogeneic hematopoietic cell transplantation (HCT) is considered 
      only if a human leukocyte antigen (HLA) matched sibling donor (MSD) is available. 
      The role of unrelated donor (URD) HCT in this patient population is not well 
      established. As advances in supportive care and donor selection have improved, 
      the use of URD HCT in such patients should be reevaluated. We analyzed the 
      outcomes of 87 consecutive children with ALL in CR2 who underwent allogeneic HCT 
      at the University of Minnesota between 1990 and 2007. Donor sources included MSD 
      bone marrow (n = 32), well and partially matched (M, n = 18) and mismatched (MM, 
      n = 16) URD bone marrow and URD umbilical cord blood (UCB, n = 21). Although the 
      incidence of neutrophil recovery was similar in all groups, the overall incidence 
      of grades II-IV acute graft-versus-host disease (aGVHD) and chronic GVHD (cGVHD) 
      was 37% and 9%, respectively, with a higher incidence of aGVHD in recipients of 
      URD grafts. Leukemia-free survival (LFS) at 5 years was lower in recipients of 
      MM-URD grafts, but was comparable in all other groups. Although relapse at 5 
      years was highest in recipients of MSD (50%), results were not significantly 
      different compared to recipients of M-URD (17%), MM-URD (6%), and UCB (33%) (P = 
      .17). The development of grades II-IV aGVHD and a first remission >3 years were 
      associated with a lower risk of relapse (relative risk [RR] 0.2, P = .03; RR 0.2. 
      P = .01 respectively). Together, these results support the continued 
      investigation of URD HCT for ALL in CR2, and suggest the timing of HCT in these 
      children should be based primarily on the risk of relapse with conventional 
      chemotherapy and not on the type of donor available.
FAU - Smith, Angela R
AU  - Smith AR
AD  - Division of Pediatric Hematology/Oncology/Blood and Marrow Transplantation, 
      University of Minnesota Medical School, Minneapolis, Minnesota, USA. 
      smith719@umn.edu
FAU - Baker, K Scott
AU  - Baker KS
FAU - Defor, Todd E
AU  - Defor TE
FAU - Verneris, Michael R
AU  - Verneris MR
FAU - Wagner, John E
AU  - Wagner JE
FAU - Macmillan, Margaret L
AU  - Macmillan ML
LA  - eng
GR  - P01 CA065493/CA/NCI NIH HHS/United States
GR  - P01-CA65493/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Biol Blood Marrow Transplant
JT  - Biology of blood and marrow transplantation : journal of the American Society for 
      Blood and Marrow Transplantation
JID - 9600628
RN  - 0 (HLA Antigens)
SB  - IM
MH  - Adolescent
MH  - Bone Marrow Transplantation
MH  - Child
MH  - Child, Preschool
MH  - Cohort Studies
MH  - Cord Blood Stem Cell Transplantation
MH  - Female
MH  - Graft Survival/immunology
MH  - Graft vs Host Disease/immunology
MH  - HLA Antigens/immunology
MH  - Hematopoietic Stem Cell Transplantation/*methods
MH  - Humans
MH  - Infant
MH  - Male
MH  - Multivariate Analysis
MH  - Neoplasm Recurrence, Local/prevention & control
MH  - Precursor Cell Lymphoblastic Leukemia-Lymphoma/immunology/*therapy
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Tissue Donors
MH  - Treatment Outcome
PMC - PMC5225985
MID - NIHMS837949
EDAT- 2009/08/08 09:00
MHDA- 2009/11/03 06:00
PMCR- 2017/01/11
CRDT- 2009/08/08 09:00
PHST- 2009/01/13 00:00 [received]
PHST- 2009/05/07 00:00 [accepted]
PHST- 2009/08/08 09:00 [entrez]
PHST- 2009/08/08 09:00 [pubmed]
PHST- 2009/11/03 06:00 [medline]
PHST- 2017/01/11 00:00 [pmc-release]
AID - S1083-8791(09)00235-3 [pii]
AID - 10.1016/j.bbmt.2009.05.005 [doi]
PST - ppublish
SO  - Biol Blood Marrow Transplant. 2009 Sep;15(9):1086-93. doi: 
      10.1016/j.bbmt.2009.05.005.