Prognostic factors for survival in children who relapsed after allogeneic hematopoietic stem cell transplantation for acute leukemia

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dc.authoridCeyhun Bozkurt / 0000-0001-6771-9894en_US
dc.authorscopusidCeyhun Bozkurt / 6602784315
dc.authorwosidCeyhun Bozkurt / AAL-5043-2021
dc.contributor.authorHazar, Volkan
dc.contributor.authorTezcan Karasu, Gülsün
dc.contributor.authorÖztürk, Gülyüz
dc.contributor.authorKüpesiz, Alphan
dc.contributor.authorAksoylar, Serap
dc.contributor.authorÖzbek, Namık
dc.contributor.authorUygun, Vedat
dc.contributor.authorİleri, Talia
dc.contributor.authorOkur, Fatma Visal
dc.contributor.authorKoçak, Ülker
dc.contributor.authorÇakı Kılıç, Suar
dc.contributor.authorAkçay, Arzu
dc.contributor.authorGüler, Elif
dc.contributor.authorKansoy, Savaş
dc.contributor.authorKarakükcü, Musa
dc.contributor.authorBayram, İbrahim
dc.contributor.authorAksu , Tekin
dc.contributor.authorYeşilipek, Akif
dc.contributor.authorKaragün, Barbaros Şahin
dc.contributor.authorYılmaz, Şebnem
dc.contributor.authorErtem, Mehmet
dc.contributor.authorUçkan, Duygu
dc.contributor.authorFışgın, Tunç
dc.contributor.authorGürsel, Orhan
dc.contributor.authorYaman, Yöntem
dc.contributor.authorBozkurt, Ceyhun
dc.contributor.authorGökçe, Müge
dc.date.accessioned2020-12-17T08:06:44Z
dc.date.available2020-12-17T08:06:44Z
dc.date.issued2020en_US
dc.departmentİstinye Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümüen_US
dc.description.abstractBackground: Post-transplant relapse has a dismal prognosis in children with acute leukemia undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT). Data on risk factors, treatment options, and outcomes are limited. Procedure: In this retrospective multicenter study in which a questionnaire was sent to all pediatric transplant centers reporting relapse after allo-HSCT for a cohort of 938 children with acute leukemia, we analyzed 255 children with relapse of acute leukemia after their first allo-HSCT. Results: The median interval from transplantation to relapse was 180 days, and the median follow-up from relapse to the last follow-up was 1844 days. The 3-year overall survival (OS) rate was 12.0%. The main cause of death was disease progression or subsequent relapse (82.6%). The majority of children received salvage treatment with curative intent without a second HSCT (67.8%), 22.0% of children underwent a second allo-HSCT, and 10.2% received palliative therapy. Isolated extramedullary relapse (hazard ratio (HR): 0.607, P = .011) and relapse earlier than 365 days post-transplantation (HR: 2.101, P < .001 for 0-180 days; HR: 1.522, P = .041 for 181-365 days) were found in multivariate analysis to be significant prognostic factors for outcome. The type of salvage therapy in chemosensitive relapse was identified as a significant prognostic factor for OS. Conclusion: A salvage approach with curative intent may be considered for patients with post-transplant relapse, even if they relapse in the first year post-transplantation. For sustainable remission, a second allo-HSCT may be recommended for patients who achieve complete remission after reinduction treatment.en_US
dc.identifier.citationHazar, V., Tezcan Karasu, G., Öztürk, G., Küpesiz, A., Aksoylar, S., Özbek, N., Uygun, V., İleri, T., Okur, F. V., Koçak, Ü., Kılıç, S. Ç., Akçay, A., Güler, E., Kansoy, S., Karakükcü, M., Bayram, İ., Aksu, T., Yeşilipek, A., Karagün, B. Ş., Yılmaz, Ş., … Turkish Pediatric Bone Marrow Transplantation Study Group (2020). Prognostic factors for survival in children who relapsed after allogeneic hematopoietic stem cell transplantation for acute leukemia. Pediatric transplantation, e13942. Advance online publication. https://doi.org/10.1111/petr.13942en_US
dc.identifier.doi10.1111/petr.13942en_US
dc.identifier.pmid33320995en_US
dc.identifier.scopus2-s2.0-85097562815en_US
dc.identifier.scopusqualityN/Aen_US
dc.identifier.urihttps://doi.org/10.1111/petr.13942
dc.identifier.urihttps://hdl.handle.net/20.500.12713/1282
dc.identifier.wosWOS:000598672000001en_US
dc.identifier.wosqualityQ4en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.institutionauthorBozkurt, Ceyhun
dc.language.isoenen_US
dc.relation.ispartofPediatric transplantationen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectAcute Leukemiaen_US
dc.subjectChildrenen_US
dc.subjectPost-Transplant Relapseen_US
dc.subjectTreatmenten_US
dc.titlePrognostic factors for survival in children who relapsed after allogeneic hematopoietic stem cell transplantation for acute leukemiaen_US
dc.typeArticleen_US

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