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Unrelated Donor Searches

Impact of marrow unrelated donor search duration on outcome of children with acute lymphoblastic leukemia in second remission

Bone Marrow Transplantation volume 32, pages 325–331 (2003)Cite this article

Summary:

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.

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References

  1. Uderzo C, Valsecchi MG, Bacigalupo A et al. Treatment of childhood acute lymphoblastic leukemia in second remission with allogeneic bone marrow transplantation and chemotherapy: ten-year experience of the Italian Bone Marrow Transplantation Group and the Italian Pediatric Hematology Oncology Association. J Clin Oncol 1995; 13: 352–358.

    Article  CAS  PubMed  Google Scholar 

  2. Uderzo C, Rondelli R, Dini G et al. High-dose vincristine, fractionated total-body irradiation and cyclophosphamide as conditioning regimen in allogeneic and autologous bone marrow transplantation for childhood acute lymphoblastic leukemia in second remission: a 7-year Italian multicentre study. Br J Hematol 1995; 89: 790–797.

    Article  CAS  Google Scholar 

  3. Messina C, Cesaro S, Rondelli R et al. Autologous bone marrow transplantation for childhood acute lymphoblastic leukemia in Italy. Bone Marrow Transplant 1998; 21: 1015–1021.

    Article  CAS  PubMed  Google Scholar 

  4. Dini G, Cornish JM, Gadner H et al. Bone marrow transplant indications for childhood leukemias: achieving a consensus. Bone Marrow Transplant 1996; 18 (Suppl. 2): 4–7.

    PubMed  Google Scholar 

  5. Balduzzi A, Gaipa G, Bonanomi S et al. Purified autologous grafting in childhood acute lymphoblastic leukemia in second remission: evidence for long term clinical and molecular remission. Leukemia 2001; 15: 50–56.

    Article  CAS  PubMed  Google Scholar 

  6. Dini G, Lanino E, Lamparelli T et al. Unrelated donor marrow transplantation: initial experience of the Italian Bone Marrow Transplant Group (GITMO). Bone Marrow Transplant 1996; 17: 55–62.

    CAS  PubMed  Google Scholar 

  7. Balduzzi A, Gooley T, Anasetti C et al. Unrelated donor marrow transplantation in children. Blood 1995; 86: 3247–3256.

    CAS  PubMed  Google Scholar 

  8. Casper J, Camitta B, Truitt R et al. Unrelated bone marrow donor transplants for children with leukemia or myelodysplasia. Blood 1995; 85: 2354–2363.

    CAS  PubMed  Google Scholar 

  9. Davies SM, Wagner JE, Shu XO et al. Unrelated donor bone marrow transplantation for children with acute leukemia. J Clin Oncol 1997; 15: 557–565.

    Article  CAS  PubMed  Google Scholar 

  10. Oakhill A, Pamphilon DH, Potter MN et al. Unrelated donor bone marrow transplantation for children with relapsed acute lymphoblastic leukaemia in second complete remission. Br J Haematol 1996; 94: 574–578.

    Article  CAS  PubMed  Google Scholar 

  11. Hongeng S, Krance RA, Bowman LC et al. Outcomes of transplantation with matched-sibling and unrelated donor bone marrow in children with leukemia. Lancet 1997; 350: 767–771.

    Article  CAS  PubMed  Google Scholar 

  12. Bone Marrow Donors Worldwide, Edition of June 2001.

  13. Aversa F, Tabilio A, Velardi A et al. Transplantation of high-risk acute leukemia with T-cell-depleted stem cells from related donor with one fully mismatched HLA haplotype. N Engl J Med 1998; 339: 1186–1193.

    Article  CAS  PubMed  Google Scholar 

  14. Locatelli F, Rocha V, Chastang C et al. Factors associated with outcome after cord blood transplantation in children with acute leukemia. Blood 1999; 93: 3662–3671.

    CAS  PubMed  Google Scholar 

  15. Pession A, Rago S, De Rosa M et al. Modello di gestione dei dati: Studio nazionale AIEOP per la leucemia acuta linfoblastica del bambino. Haematologica 1987; 72: 249–254.

    Google Scholar 

  16. Pession A, Rondelli R, Paolucci P et al. Hematopoietic stem cell transplantation in childhood: report from the Bone Marrow Transplantation (BMT) group of the Associazione Italiana Ematologia Oncologia Pediatrica (AIEOP). Haematologica 2000; 85: 638–646.

    CAS  PubMed  Google Scholar 

  17. Conter V, Aricò M, Valsecchi MG et al. Extended intrathecal methotrexate may replace cranial irradiation for prevention of CNS relapse in intermediate risk ALL children treated with BFM-based intensive chemotherapy. J Clin Oncol 1995; 13: 2497–2502.

    Article  CAS  PubMed  Google Scholar 

  18. Vecchi V, Aricò M, Basso G et al. Risk-directed therapy for childhood acute lymphoblastic leukemia. Cancer 1993; 72: 2517–2524.

    Article  CAS  PubMed  Google Scholar 

  19. Conter V, Aricò M, Valsecchi MG et al. Intensive BFM chemotherapy for childhood ALL: interim analysis of the AIEOP-ALL 91 study. Haematologica 1998; 83: 791–799.

    CAS  PubMed  Google Scholar 

  20. Buhrer C, Hartmann R, Fengler R et al. Superior prognosis in combined compared to isolated bone marrow relapse salvage therapy of childhood acute lymphoblastic leukemia. Med Pediatr Oncol 1993; 21: 470–476.

    Article  CAS  PubMed  Google Scholar 

  21. Rossi MR, Masera G, Zurlo MG et al. Randomized multicentric Italian study on two treatment regimens for marrow relapse in childhood acute lymphoblastic leukemia. Pediatr Hematol Oncol 1986; 3: 1–9.

    Article  CAS  PubMed  Google Scholar 

  22. Giona F, Testi AM, Annino L et al. Treatment of primary and relapsed acute lymphoblastic leukaemia in children and adults: the GIMEMA/AIEOP experience. Br J Haematol 1994; 86: 55–61.

    Article  CAS  PubMed  Google Scholar 

  23. Dini G, Lamparelli T, Rondelli R et al. Unrelated donor marrow transplantation for chronic myelogenous leukaemia. Br J Haematol 1998; 102: 544–552.

    Article  CAS  PubMed  Google Scholar 

  24. Locatelli F, Zecca M, Messina C et al. Improvement over time in outcome for children with acute lymphoblastic leukemia in second remission given hematopoietic stem cell transplantation from unrelated donors. Leukemia 2002; 16: 2228–2237.

    Article  CAS  PubMed  Google Scholar 

  25. Marubini E, Valsecchi MG . Analysing Survival Data from Clinical Trials and Observational Studies. Wiley: New York, 1995.

    Google Scholar 

  26. Gustafsson A, Remberger M, Winiarski J, Ringden O . Unrelated bone marrow transplantation in children: outcome and a comparison with sibling donor grafting. Bone Marrow Transplant 2000; 25: 1059–1065.

    Article  CAS  PubMed  Google Scholar 

  27. Saarinen-Pihkala UM, Gustafsson G, Ringdén O et al. No disadvantage in outcome of using matched unrelated donors as compared with matched sibling donors for bone marrow transplantation in children with acute lymphoblastic leukemia in second remission. J Clin Oncol 2001; 19: 3406–3414.

    Article  CAS  PubMed  Google Scholar 

  28. Petersdorf EW, Gooley TA, Anasetti C et al. Optimizing outcome after unrelated marrow transplantation by comprehensive matching of HLA class I and II alleles in the donor and recipient. Blood 1998; 92: 3515–3520.

    CAS  PubMed  Google Scholar 

  29. Souillet G, Rey S, Bertrand Y et al. Outcome of unrelated bone marrow donor searches in 174 children resulting in 45 patients transplanted in the HLA-matched and –mismatched situation. Bone Marrow Transplant 2000; 26: 31–43.

    Article  CAS  PubMed  Google Scholar 

  30. Borgmann A, Schmid H, Hartmann R et al. Autologous bone-marrow transplants compared with chemotherapy for children with acute lymphoblastic leukaemia in second remission: a matched pair analysis. Lancet 1995; 346: 873–876.

    Article  CAS  PubMed  Google Scholar 

  31. Beatty PG, Clift RA, Mickelson EM et al. Marrow transplantation from related donors other than HLA-identical siblings. N Engl J Med 1985; 313: 765–771.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

We would like to thank data managers from all the centers for their help in collecting data and answering our queries; Roberta Cancedda from G Gaslini Institute (Genova); Francesca Predieri from CO FONOP-AIEOP (Bologna) for their assistance with data management; partially supported by Ricerca Finalizzata 2002, by Compagnia San Paolo, by Fondazione CARIGE.

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Author notes

  1. A Busca

    Present address: UOA Ematologia, Ospedale San Giovanni Battista, Torino, Italy

Authors and Affiliations

  1. UO Ematologia ed Oncologia Pediatrica, Istituto G Gaslini, Genova, Italy

    G Dini, C Micalizzi, E Lanino & C Manzitti

  2. Dipartimento di Medicina Clinica, Sezione di Statistica Medica, Prevenzione e Biotecnologie Sanitarie, Università di Milano-Bicocca, Italy

    M Grazia Valsecchi & S Galimberti

  3. Dipartimento Scienze Pediatriche e Adolescentologia, Ospedale Regina Margherita Università di Torino, Italy

    A Busca

  4. Clinica Pediatrica, Università di Milano Bicocca, Ospedale S Gerardo Monza, Italy

    A Balduzzi

  5. Dipartimento Biotecnologie Cellulari ed Ematologia, Università La Sapienza Roma, Italy

    W Arcese

  6. Dipartimento di Pediatria, Clinica Oncoematologica Pediatrica, Università di Padova, Italy

    S Cesaro

  7. Dipartimento Scienze Pediatriche Mediche e Chirurgiche, Ospedale S Orsola Malpighi, Bologna, Italy

    A Prete & A Pession

  8. Clinica Pediatrica, Università di Trieste, Italy

    M Rabusin

  9. Clinica Pediatrica, Università di Brescia, Italy

    E Mazzolari

  10. Unità di Terapia Intensiva Ematologica per il Trapianto Emopoietico, Ospedale Civile di Pescara, Italy

    P Di Bartolomeo

  11. Italian Bone Marrow Donor Registry, Italy

    N Sacchi

  12. Oncoematologia Pediatrica, IRCCS Policlinico S Matteo, Università di Pavia, Italy

    G Giorgiani & F Locatelli

  13. Divisione Ematologia II, Ospedale Civile Genova, Italy

    T Lamparelli

  14. Clinica Pediatrica, Ospedale S Chiara Università di Pisa, Italy

    C Favre

  15. Cattedra di Ematologia, Università di Firenze, Italy

    A Bosi

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  1. G Dini
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  2. M Grazia Valsecchi
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Dini, G., Valsecchi, M., Micalizzi, C. et al. Impact of marrow unrelated donor search duration on outcome of children with acute lymphoblastic leukemia in second remission. Bone Marrow Transplant 32, 325–331 (2003). https://doi.org/10.1038/sj.bmt.1704132

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  • DOI: https://doi.org/10.1038/sj.bmt.1704132

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