{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T12:44:57Z","timestamp":1793277897267,"version":"4.5.0"},"reference-count":34,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T00:00:00Z","timestamp":1759190400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>Evolution of acute myeloid leukaemia (AML) treatments and transplantation procedures may affect outcomes after second haematopoietic stem cell transplantation (HSCT2) for relapsed paediatric AML. We analysed 345 paediatric patients reported to the European Society for Bone Marrow Transplantation (EBMT) registry for HSCT2 performed for AML relapse post\u2010HSCT between 2000 and 2022. Multivariable analyses were adjusted for sex, age, transplant period, donor, disease status pre\u2010HSCT2, cytogenetics, conditioning, total body irradiation (TBI) and post\u2010first haematopoietic stem cell transplantation (HSCT1) remission duration. At three years leukaemia\u2010free survival (LFS), overall survival (OS), non\u2010relapse mortality (NRM), relapse incidence (RI) and graft\u2010versus\u2010host disease (GVHD)\/relapse\u2010free survival (GRFS) were 30.2%, 37.5%, 19.1%, 50.7% and 20.7% respectively. Compared with the 2000\u20132013 period, HSCT2 performed in 2014\u20132022 had better LFS (hazard ration [HR]: 0.66, 95% confidence interval [95% CI]: 0.48\u20130.90; 3\u2010year: 34.3% vs. 26.3%), OS (HR: 0.60, 95% CI: 0.42\u20130.84; 3\u2010year: 42.9% vs. 32.8%), RI (HR: 0.66, 95% CI: 0.46\u20130.98; 3\u2010year: 46.0% vs. 54.7%) and GRFS (HR: 0.65, 95% CI: 0.48\u20130.90; 3\u2010year: 25.3% vs. 16.1%) while NRM and GVHD incidence were stable. Relapse &gt;6\u2009months post\u2010HSCT1 and remission pre\u2010HSCT2 were associated with better LFS, OS and RI. Conditioning and cytogenetics did not influence outcomes. Mismatched unrelated donor negatively affected OS. These results highlight the improving survival after HSCT2 and support it in selected patients, particularly those relapsing later and in remission at HSCT2.<\/jats:p>","DOI":"10.1111\/bjh.70167","type":"journal-article","created":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T03:00:27Z","timestamp":1759287627000},"page":"2496-2506","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Outcomes after a second allogeneic haematopoietic stem cell transplant for relapsed paediatric acute myeloid leukaemia improved over time: A study from the\n                    <scp>EBMT<\/scp>\n                    Paediatric Diseases Working Party"],"prefix":"10.1111","volume":"207","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-4620-5329","authenticated-orcid":false,"given":"Nimrod","family":"Buchbinder","sequence":"first","affiliation":[{"name":"Service d'Immuno\u2010H\u00e9mato\u2010Oncologie P\u00e9diatrique H\u00f4pital Charles Nicolle  Rouen France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Michel","sequence":"additional","affiliation":[{"name":"Service d'Immuno\u2010H\u00e9mato\u2010Oncologie P\u00e9diatrique H\u00f4pital Charles Nicolle  Rouen France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnaud","family":"Dalissier","sequence":"additional","affiliation":[{"name":"EBMT Paris Study Unit Saint Antoine Hospital, INSERM UMR\u2010S 938, Sorbonne University  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Kleinschmidt","sequence":"additional","affiliation":[{"name":"EBMT Paris Study Unit Saint Antoine Hospital, INSERM UMR\u2010S 938, Sorbonne University  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7976-3654","authenticated-orcid":false,"given":"Franco","family":"Locatelli","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology and Oncology IRRCS Ospedale Pediatrico Bambino Ges\u00f9 Catholic University of the Sacred Heart  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0016-6698","authenticated-orcid":false,"given":"Alexei","family":"Maschan","sequence":"additional","affiliation":[{"name":"Federal Research Center for Pediatric Hematology  Moscow Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6046-8428","authenticated-orcid":false,"given":"Robert","family":"Wynn","sequence":"additional","affiliation":[{"name":"Department of Paediatric Haematology, Bone Marrow Unit Royal Manchester Children's Hospital  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franca","family":"Fagioli","sequence":"additional","affiliation":[{"name":"Onco\u2010Ematologia Pediatrica, Centro Trapianti Cellule Staminali Ospedale Infantile Regina Margherita  Torino Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8818-1744","authenticated-orcid":false,"given":"Marco","family":"Zecca","sequence":"additional","affiliation":[{"name":"Fondazione IRCCS Policlinico San Matteo Pediatric Hematology\u2010Oncology  Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Jubert","sequence":"additional","affiliation":[{"name":"CHU Bordeaux Groupe Hospitalier Pellegrin\u2010Enfants  Bordeaux France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birgitta","family":"Versluys","sequence":"additional","affiliation":[{"name":"Princess Maxima Center\/University Hospital for Children (WKZ), Stem Cell Transplantation  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petr","family":"Sedlacek","sequence":"additional","affiliation":[{"name":"Department of Paediatric Haematology and Oncology University Hospital Motol  Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ludmila","family":"Zubarovskaya","sequence":"additional","affiliation":[{"name":"RM Gorbacheva Research Institute, Pavlov University  Saint Petersburg Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4845-5616","authenticated-orcid":false,"given":"Marta","family":"Gonzalez Vicent","sequence":"additional","affiliation":[{"name":"Ni\u00f1o Jesus Children's Hospital Stem Cell Transplant Unit  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Biffi","sequence":"additional","affiliation":[{"name":"Clinica di Oncoematologia Pediatrica Dipartimento di Pediatria  Padova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00e9rard","family":"Michel","sequence":"additional","affiliation":[{"name":"D\u00e9partement H\u00e9matologie Oncologie P\u00e9diatrique H\u00f4pital de la Timone  Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oana","family":"Mirci\u2010Danicar","sequence":"additional","affiliation":[{"name":"Department of Paediatric Oncology\/BMT Bristol Royal Hospital for Children  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang","family":"Holter","sequence":"additional","affiliation":[{"name":"Stem Cell Transplantation Unit St. Anna Kinderspital  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Ansari","sequence":"additional","affiliation":[{"name":"Cansearch Research Platform for Pediatric Oncology and Hematology, Faculty of Medicine, Department of Pediatrics, Gynecology and 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