Outcomes following autologous hematopoietic stem cell transplant for patients with relapsed Wilms' tumor: A CIBMTR retrospective analysis

Marcio Malogolowkin, M. T. Hemmer, J. Le-Rademacher, G. A. Hale, P. A. Mehta, A. R. Smith, C. Kitko, A. Abraham, H. Abdel-Azim, C. Dandoy, M. Angel Diaz, R. P. Gale, G. Guilcher, R. Hayashi, S. Jodele, K. A. Kasow, M. L. MacMillian, M. Thakar, B. M. Wirk, A. WoolfreyE. L. Thiel

Research output: Contribution to journalArticle

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Abstract

Despite the marked improvement in the overall survival (OS) for patients diagnosed with Wilms' tumor (WT), the outcomes for those who experience relapse have remained disappointing. We describe the outcomes of 253 patients with relapsed WT who received high-dose chemotherapy (HDT) followed by autologous hematopoietic stem cell transplant (HCT) between 1990 and 2013, and were reported to the Center for International Blood and Marrow Transplantation Research. The 5-year estimates for event-free survival (EFS) and OS were 36% (95% confidence interval (CI); 29-43%) and 45% (95 CI; 38-51%), respectively. Relapse of primary disease was the cause of death in 81% of the population. EFS, OS, relapse and transplant-related mortality showed no significant differences when broken down by disease status at transplant, time from diagnosis to transplant, year of transplant or conditioning regimen. Our data suggest that HDT followed by autologous HCT for relapsed WT is well tolerated and outcomes are similar to those reported in the literature. As attempts to conduct a randomized trial comparing maintenance chemotherapy with consolidation versus HDT followed by stem cell transplant have failed, one should balance the potential benefits with the yet unknown long-term risks. As disease recurrence continues to be the most common cause of death, future research should focus on the development of consolidation therapies for those patients achieving complete response to therapy.

Original languageEnglish (US)
Pages (from-to)1549-1555
Number of pages7
JournalBone Marrow Transplantation
Volume52
Issue number11
DOIs
StatePublished - Nov 1 2017

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Wilms Tumor
Hematopoietic Stem Cells
Transplants
Recurrence
Drug Therapy
Disease-Free Survival
Survival
Cause of Death
Maintenance Chemotherapy
Confidence Intervals
Stem Cells
Transplantation
Bone Marrow
Mortality
Therapeutics
Research
Population

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Outcomes following autologous hematopoietic stem cell transplant for patients with relapsed Wilms' tumor : A CIBMTR retrospective analysis. / Malogolowkin, Marcio; Hemmer, M. T.; Le-Rademacher, J.; Hale, G. A.; Mehta, P. A.; Smith, A. R.; Kitko, C.; Abraham, A.; Abdel-Azim, H.; Dandoy, C.; Angel Diaz, M.; Gale, R. P.; Guilcher, G.; Hayashi, R.; Jodele, S.; Kasow, K. A.; MacMillian, M. L.; Thakar, M.; Wirk, B. M.; Woolfrey, A.; Thiel, E. L.

In: Bone Marrow Transplantation, Vol. 52, No. 11, 01.11.2017, p. 1549-1555.

Research output: Contribution to journalArticle

Malogolowkin, M, Hemmer, MT, Le-Rademacher, J, Hale, GA, Mehta, PA, Smith, AR, Kitko, C, Abraham, A, Abdel-Azim, H, Dandoy, C, Angel Diaz, M, Gale, RP, Guilcher, G, Hayashi, R, Jodele, S, Kasow, KA, MacMillian, ML, Thakar, M, Wirk, BM, Woolfrey, A & Thiel, EL 2017, 'Outcomes following autologous hematopoietic stem cell transplant for patients with relapsed Wilms' tumor: A CIBMTR retrospective analysis', Bone Marrow Transplantation, vol. 52, no. 11, pp. 1549-1555. https://doi.org/10.1038/bmt.2017.178
Malogolowkin, Marcio ; Hemmer, M. T. ; Le-Rademacher, J. ; Hale, G. A. ; Mehta, P. A. ; Smith, A. R. ; Kitko, C. ; Abraham, A. ; Abdel-Azim, H. ; Dandoy, C. ; Angel Diaz, M. ; Gale, R. P. ; Guilcher, G. ; Hayashi, R. ; Jodele, S. ; Kasow, K. A. ; MacMillian, M. L. ; Thakar, M. ; Wirk, B. M. ; Woolfrey, A. ; Thiel, E. L. / Outcomes following autologous hematopoietic stem cell transplant for patients with relapsed Wilms' tumor : A CIBMTR retrospective analysis. In: Bone Marrow Transplantation. 2017 ; Vol. 52, No. 11. pp. 1549-1555.
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AU - Malogolowkin, Marcio

AU - Hemmer, M. T.

AU - Le-Rademacher, J.

AU - Hale, G. A.

AU - Mehta, P. A.

AU - Smith, A. R.

AU - Kitko, C.

AU - Abraham, A.

AU - Abdel-Azim, H.

AU - Dandoy, C.

AU - Angel Diaz, M.

AU - Gale, R. P.

AU - Guilcher, G.

AU - Hayashi, R.

AU - Jodele, S.

AU - Kasow, K. A.

AU - MacMillian, M. L.

AU - Thakar, M.

AU - Wirk, B. M.

AU - Woolfrey, A.

AU - Thiel, E. L.

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