{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T18:31:35Z","timestamp":1788201095263,"version":"build-2803163510"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,11,28]],"date-time":"2017-11-28T00:00:00Z","timestamp":1511827200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Relapse remains the major cause of treatment failure in children with high\u2010risk acute lymphoblastic leukaemia (<jats:styled-content style=\"fixed-case\">ALL<\/jats:styled-content>) undergoing allogeneic haematopoietic stem\u2010cell transplantation (allo\u2010<jats:styled-content style=\"fixed-case\">SCT<\/jats:styled-content>). Prognosis is considered dismal but data on risk factors and outcome are lacking from prospective studies. We analysed 242 children with recurrence of <jats:styled-content style=\"fixed-case\">ALL<\/jats:styled-content> after first allo\u2010<jats:styled-content style=\"fixed-case\">SCT<\/jats:styled-content> enrolled in the Berlin\u2010Frankfurt\u2010Munster (<jats:styled-content style=\"fixed-case\">BFM<\/jats:styled-content>) <jats:styled-content style=\"fixed-case\">ALL<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">SCT<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">BFM<\/jats:styled-content> 2003 and <jats:styled-content style=\"fixed-case\">ALL<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">SCT<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">BFM<\/jats:styled-content> international 2007 studies. Median time from allo\u2010<jats:styled-content style=\"fixed-case\">SCT<\/jats:styled-content> to relapse was 7\u00b77\u00a0months; median follow\u2010up from relapse after allo\u2010<jats:styled-content style=\"fixed-case\">SCT<\/jats:styled-content> until last follow\u2010up was 3\u00b74\u00a0years. The 3\u2010year event\u2010free survival (<jats:styled-content style=\"fixed-case\">EFS<\/jats:styled-content>) was 15% and overall survival (<jats:styled-content style=\"fixed-case\">OS<\/jats:styled-content>) was 20%. The main cause of death was disease progression or relapse (86\u00b75%). The majority of children (48%) received salvage therapy without second allo\u2010<jats:styled-content style=\"fixed-case\">SCT<\/jats:styled-content>, 26% of the children underwent a second allo\u2010<jats:styled-content style=\"fixed-case\">SCT<\/jats:styled-content> and 25% received palliative treatment only. In multivariate analyses, age, site of relapse, time to relapse and type of salvage therapy were identified as significant prognostic factors for <jats:styled-content style=\"fixed-case\">OS<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">EFS<\/jats:styled-content>, whereas factors associated with first <jats:styled-content style=\"fixed-case\">SCT<\/jats:styled-content> were not statistically significant. Combined approaches incorporating novel immunotherapeutic treatment options and second allo\u2010<jats:styled-content style=\"fixed-case\">SCT<\/jats:styled-content> hold promise to improve outcome in children with post allo\u2010<jats:styled-content style=\"fixed-case\">SCT<\/jats:styled-content> relapse.<\/jats:p>","DOI":"10.1111\/bjh.14965","type":"journal-article","created":{"date-parts":[[2017,11,29]],"date-time":"2017-11-29T15:40:07Z","timestamp":1511970007000},"page":"82-89","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":72,"title":["Outcome of relapse after allogeneic <scp>HSCT<\/scp> in children with <scp>ALL<\/scp> enrolled in the <scp>ALL<\/scp>\u2010<scp>SCT<\/scp> 2003\/2007 trial"],"prefix":"10.1111","volume":"180","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4577-0503","authenticated-orcid":false,"given":"Michaela","family":"Kuhlen","sequence":"first","affiliation":[{"name":"Department of Paediatric 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Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isaac","family":"Yaniv","sequence":"additional","affiliation":[{"name":"Ezer Mizion Bone Marrow Donor Registry Petach Tikva Israel"},{"name":"Bone Marrow Transplant Unit Schneider Children's Medical Centre of Israel Petach Tikva Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne","family":"Ifversen","sequence":"additional","affiliation":[{"name":"Department for Children and Adolescents Rigahospitalet Copenhagen University Hospital Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petr","family":"Sedlacek","sequence":"additional","affiliation":[{"name":"Department of Paediatric Haematology and Oncology Teaching Hospital Motol Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tayfun","family":"Guengoer","sequence":"additional","affiliation":[{"name":"Division of Stem Cell Transplantation University Children's Hospital Z\u00fcrich Z\u00fcrich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Lang","sequence":"additional","affiliation":[{"name":"University Hospital Tuebingen Tuebingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Bader","sequence":"additional","affiliation":[{"name":"Department for Children and Adolescents Division for Stem Cell Transplantation and Immunology University Hospital Frankfurt Goethe University Frankfurt Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabina","family":"Sufliarska","sequence":"additional","affiliation":[{"name":"Department of Paediatric Haematology and Oncology Haematopoietic Stem Cell Transplantation Unit Comenius University Children's Hospital Bratislava Bratislava Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana","family":"Balduzzi","sequence":"additional","affiliation":[{"name":"Clinica Pediatrica 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