Outcome of 333 children with acute myeloid leukaemia relapsing after a first allogeneic haematopoietic stem cell transplantation was analyzed. Four-year probability of overall survival (4y-pOS) was 14%. 4y-pOS for 122 children receiving a second haematopoietic stem cell transplantation was 31% and 3% for those that did not (P = <0·0001). Achievement of a subsequent remission impacted survival (P = <0·0001). For patients receiving a second transplant survival with or without achieving a subsequent remission was comparable. Graft source (bone marrow vs. peripheral blood stem cells, P = 0·046) and donor choice (matched family vs. matched unrelated donor, P = 0·029) positively impacted survival after relapse. Disease recurrence and non-relapse mortality at four years reached 45% and 22%.

Aarhus University Hospital Arhus Sweden

Australasian Bone Marrow Transplant Recipient Registry Darlinghurst NSW Australia

Cansearch Research Laboratory Geneva University Hospital Geneva University Geneva Switzerland

Clinica Pediatrica Università degli Studi di Milano Bicocca Fondazione MBBM Ospedale San Gerardo Monza Italy

Division of Pediatric Hematology and Oncology Department of Pediatrics Universities of Medical University Hannover Hannover Germany

Ghent University Hospital Ghent Belgium

Institution of Clinical Sciences Sahlgrenska University Hospital Gothenburg Sweden

IRCCS Bambino Gesù Children's Hospital Rome Italy

Princess Maxima Centre for Pediatric Oncology Childrens University Hospital Utrecht Utrecht Netherlands

Queensland Children's Hospital and The University of Queensland Brisbane QLD Australia

Sapienza University of Rome Rome Italy

Schneider Children's Medical Center of Israel Petach Tikva Israel

St Anna Childrens Hospital Vienna Austria

University Children's Hospital Zurich CHE Zurich Switzerland

University Hospital Motol Charles University Prague Czech Republic

University Medical Center Utrecht Utrecht Netherlands

University of Duisburg Essen Essen Germany

University of Medical Sciences Poznan Poland

Willem Alexander Children's Hospital Leiden University Medical Centre Leiden Netherlands

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