Christina Peters1, Martin Schrappe2, Arend von Stackelberg2, André Schrauder2, Peter Bader2, Wolfram Ebell2, Peter Lang2, Karl-Walter Sykora2, Johanna Schrum2, Bernhard Kremens2, Karoline Ehlert2, Michael H Albert2, Roland Meisel2, Susanne Matthes-Martin2, Tayfun Gungor2, Wolfgang Holter2, Brigitte Strahm2, Bernd Gruhn2, Ansgar Schulz2, Wilhelm Woessmann2, Ulrike Poetschger2, Martin Zimmermann2, Thomas Klingebiel2. 1. Christina Peters, Susanne Matthes-Martin, and Ulrike Poetschger, St Anna Children's Hospital, Vienna, Austria; Martin Schrappe, University Medical Center Schleswig-Holstein and Christian-Albrechts-University Kiel; André Schrauder, Kinderarztpraxis am Aalborgring, Kiel; Arend von Stackelberg and Wolfram Ebell, Charité-Children's Hospital Berlin, Berlin; Peter Bader and Thomas Klingebiel, Johann Wolfgang Goethe University, Frankfurt; Peter Lang, University Hospital Tübingen, Tübingen; Karl-Walter Sykora and Martin Zimmerman, Hannover Medical School, Hannover; Johanna Schrum, University Medical Center Hamburg-Eppendorf, Hamburg; Bernhard Kremens, University Hospital Essen, Essen; Karoline Ehlert, University Clinic Greifswald, Greifswald; Michael H. Albert, Dr. von Hauner University Children's Hospital, München; Roland Meisel, University Hospital Düsseldorf, Düsseldorf; Wolfgang Holter, Children's University Hospital Erlangen, Erlangen; Brigitte Strahm, University Hospital Freiburg, Freiburg; Bernd Gruhn, University Hospital Jena, Jena; Ansgar Schulz, University Hospital Ulm, Ulm; Wilhelm Woessmann, University Clinic Giessen, Giessen, Germany; and Tayfun Gungor, University Children's Hospital Zürich, Zürich, Switzerland. christina.peters@stanna.at. 2. Christina Peters, Susanne Matthes-Martin, and Ulrike Poetschger, St Anna Children's Hospital, Vienna, Austria; Martin Schrappe, University Medical Center Schleswig-Holstein and Christian-Albrechts-University Kiel; André Schrauder, Kinderarztpraxis am Aalborgring, Kiel; Arend von Stackelberg and Wolfram Ebell, Charité-Children's Hospital Berlin, Berlin; Peter Bader and Thomas Klingebiel, Johann Wolfgang Goethe University, Frankfurt; Peter Lang, University Hospital Tübingen, Tübingen; Karl-Walter Sykora and Martin Zimmerman, Hannover Medical School, Hannover; Johanna Schrum, University Medical Center Hamburg-Eppendorf, Hamburg; Bernhard Kremens, University Hospital Essen, Essen; Karoline Ehlert, University Clinic Greifswald, Greifswald; Michael H. Albert, Dr. von Hauner University Children's Hospital, München; Roland Meisel, University Hospital Düsseldorf, Düsseldorf; Wolfgang Holter, Children's University Hospital Erlangen, Erlangen; Brigitte Strahm, University Hospital Freiburg, Freiburg; Bernd Gruhn, University Hospital Jena, Jena; Ansgar Schulz, University Hospital Ulm, Ulm; Wilhelm Woessmann, University Clinic Giessen, Giessen, Germany; and Tayfun Gungor, University Children's Hospital Zürich, Zürich, Switzerland.
Abstract
PURPOSE: Although hematopoietic stem-cell transplantation is widely performed in children with high-risk acute lymphoblastic leukemia (ALL), the influence of donor types is poorly understood. Thus, transplantation outcomes were compared in the prospective multinational Berlin-Frankfurt-Muenster (BFM) study group trial: ALL-SCT-BFM 2003 (Allogeneic Stem Cell Transplantation in Children and Adolescents with Acute Lymphoblastic Leukemia). PATIENTS AND METHODS: After conditioning with total-body irradiation and etoposide, 411 children with high-risk ALL received highly standardized stem-cell transplantations during the first or later remissions. Depending on donor availability, grafts originated from HLA-genoidentical siblings or from HLA-matched unrelated donors who were identified and matched by high-resolution allelic typing and were compatible in at least 9 of 10 HLA loci. RESULTS: Four-year event-free survival (± standard deviation [SD]) did not differ between patients with transplantations from unrelated or sibling donors (0.67 ± 0.03 v 0.71 ± 0.05; P = .405), with cumulative incidences of nonrelapse mortality (± SD) of 0.10 ± 0.02 and 0.03 ± 0.02 (P = .017) and relapse rates (± SD) of 0.22 ± 0.02 and 0.24 ± 0.04 (P = .732), respectively. Among recipients of transplantations from unrelated donors, no significant differences in event-free survival, overall survival, or nonrelapse mortality were observed between 9/10 and 10/10 matched grafts or between peripheral blood stem cells and bone marrow. The absence of chronic graft-versus-host disease had no effect on event-free survival. Engraftment was faster after bone marrow transplantation from siblings and was associated with fewer severe infections and pulmonary complications. CONCLUSION: Outcome among high-risk pediatric patients with ALL after hematopoietic stem-cell transplantation was not affected by donor type. Standardized myeloablative conditioning produced a low incidence of treatment-related mortality and effective control of leukemia.
PURPOSE: Although hematopoietic stem-cell transplantation is widely performed in children with high-risk acute lymphoblastic leukemia (ALL), the influence of donor types is poorly understood. Thus, transplantation outcomes were compared in the prospective multinational Berlin-Frankfurt-Muenster (BFM) study group trial: ALL-SCT-BFM 2003 (Allogeneic Stem Cell Transplantation in Children and Adolescents with Acute Lymphoblastic Leukemia). PATIENTS AND METHODS: After conditioning with total-body irradiation and etoposide, 411 children with high-risk ALL received highly standardized stem-cell transplantations during the first or later remissions. Depending on donor availability, grafts originated from HLA-genoidentical siblings or from HLA-matched unrelated donors who were identified and matched by high-resolution allelic typing and were compatible in at least 9 of 10 HLA loci. RESULTS: Four-year event-free survival (± standard deviation [SD]) did not differ between patients with transplantations from unrelated or sibling donors (0.67 ± 0.03 v 0.71 ± 0.05; P = .405), with cumulative incidences of nonrelapse mortality (± SD) of 0.10 ± 0.02 and 0.03 ± 0.02 (P = .017) and relapse rates (± SD) of 0.22 ± 0.02 and 0.24 ± 0.04 (P = .732), respectively. Among recipients of transplantations from unrelated donors, no significant differences in event-free survival, overall survival, or nonrelapse mortality were observed between 9/10 and 10/10 matched grafts or between peripheral blood stem cells and bone marrow. The absence of chronic graft-versus-host disease had no effect on event-free survival. Engraftment was faster after bone marrow transplantation from siblings and was associated with fewer severe infections and pulmonary complications. CONCLUSION: Outcome among high-risk pediatric patients with ALL after hematopoietic stem-cell transplantation was not affected by donor type. Standardized myeloablative conditioning produced a low incidence of treatment-related mortality and effective control of leukemia.
Authors: Don S Dizon; Lada Krilov; Ezra Cohen; Tara Gangadhar; Patricia A Ganz; Thomas A Hensing; Stephen Hunger; Smitha S Krishnamurthi; Andrew B Lassman; Merry Jennifer Markham; Erica Mayer; Michael Neuss; Sumanta Kumar Pal; Lisa C Richardson; Richard Schilsky; Gary K Schwartz; David R Spriggs; Miguel Angel Villalona-Calero; Gina Villani; Gregory Masters Journal: J Clin Oncol Date: 2016-02-04 Impact factor: 44.544
Authors: M Simonin; A Dalissier; M Labopin; A Willasch; M Zecca; A Mouhab; A Chybicka; A Balduzzi; L Volin; C Peters; P Bader; J-H Dalle Journal: Bone Marrow Transplant Date: 2017-04-10 Impact factor: 5.483
Authors: Jessica I Hoell; Sebastian Ginzel; Michaela Kuhlen; Andreas Kloetgen; Michael Gombert; Ute Fischer; Daniel Hein; Salih Demir; Martin Stanulla; Martin Schrappe; Udo Zur Stadt; Peter Bader; Florian Babor; Friedhelm Schuster; Brigitte Strahm; Julia Alten; Anja Moericke; Gabriele Escherich; Arend von Stackelberg; Ralf Thiele; Alice C McHardy; Christina Peters; Beat Bornhauser; Jean-Pierre Bourquin; Stefan Krause; Juergen Enczmann; Lüder Hinrich Meyer; Cornelia Eckert; Arndt Borkhardt; Roland Meisel Journal: Blood Adv Date: 2019-10-22
Authors: Sergio A Giralt; Charles F LeMaistre; Navneet S Majhail; Stephanie H Farnia; Paul A Carpenter; Richard E Champlin; Stephen Crawford; David I Marks; James L Omel; Paul J Orchard; Jeanne Palmer; Wael Saber; Bipin N Savani; Paul A Veys; Christopher N Bredeson Journal: Biol Blood Marrow Transplant Date: 2015-08-07 Impact factor: 5.742