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Review
. 2010 Aug;3(4):429-41.
doi: 10.1586/ehm.10.32.

Relapse after allogeneic stem cell transplantation

A John Barrett  1 , Minoo Battiwalla
Affiliations
Review

Relapse after allogeneic stem cell transplantation

A John Barrett et al. Expert Rev Hematol. 2010 Aug.

Abstract

Since allogeneic stem cell transplantation (SCT) represents an intensive curative treatment for high-risk malignancies, its failure to prevent relapse leaves few options for successful salvage treatment. While many patients have a high early mortality from relapse, some respond and have sustained remissions, and a minority has a second chance of cure with appropriate therapy. The prognosis for relapsed hematological malignancies after SCT depends on four factors: the time elapsed from SCT to relapse (with relapses occurring within 6 months having the worst prognosis), the disease type (with chronic leukemias and some lymphomas having a second possibility of cure with further treatment), the disease burden and site of relapse (with better treatment success if disease is treated early), and the conditions of the first transplant (with superior outcome for patients where there is an opportunity to increase either the alloimmune effect, the specificity of the antileukemia effect with targeted agents or the intensity of the conditioning in a second transplant). These features direct treatments toward either modified second transplants, chemotherapy, targeted antileukemia therapy, immunotherapy or palliative care.

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Conflict of interest statement

Financial & competing interests disclosure

This work was supported (in part) by the Intramural Research Program of the NHLBI, NIH. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Figures

Figure 1
Figure 1. Causes of death after allogeneic stem cell transplantation reported to Center for International Blood and Marrow Transplant Research 2002–2007
GVHD: Graft-versus-host disease; IPn: Interstitial pneumonitis.
See this image and copyright information in PMC

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