Factors associated with improved outcomes after second allogeneic hematopoietic cell transplantation for relapsed pediatric XXXX .

@entity1 @entity981 @entity3052 @entity1778 @entity348 @entity1860
UNASSIGNED: A second allogeneic (allo) hematopoietic cell transplant (HCT) is an important therapeutic consideration for @entity1 relapsing after their first. We conducted a retrospective review of 41 pediatric @entity1 with @entity1778 that underwent a second allo-HCT at our institution. Overall, 53.7 and 43.9  % of @entity1 were alive and disease-free at 1 and 5  years, respectively, after the second allo-HCT. The factors affecting outcome by both univariate and multivariate analysis were interval between transplants and the use of a myeloablative conditioning (MAC) regimen prior to second transplant. Outcomes were inferior in @entity1 who received their second transplant <6  months from their first HCT when compared to @entity1 in whom the interval between HCTs was 6-12 or more than 12  months. Interval between HCTs was also significant when each @entity1778 ( @entity981 ( @entity981 ) n   =   21, @entity3052 ( @entity3052 ) n   =   11, and @entity1860 ( @entity1860 ) n   =   7) was analyzed separately. In univariate analysis, use of the same donor and use of a matched sibling donor resulted in significant improved outcome. There was not a significant association between disease-free survival (DFS) and age, remission status, use of @entity348 ( @entity348 ) before second HCT, or @entity1778 . Second allogeneic HCT can be a curative therapeutic option for @entity1778 @entity1 relapsing after their first transplant. As more targeted therapies have become available, @entity1 that relapse after first HCT are more likely to achieve remission. Therefore, it is anticipated that there will be more candidates for second HCT with improved performance and remission status, ultimately leading to a better outcome with the second HCT.
