Until a couple years ago, there was not a lot of appetite to go for a second transplant after having a relapse. Some centers, because there was a later relapse, or the kids or adults was in a pretty okay clinical condition. So some of the centers started to do second allotransplants. That’s what we did in the Princess Maxima as well as MSKCC, the center where I’m in now. In the abstract, you are referring to, we have collected the data from these two centers...
Until a couple years ago, there was not a lot of appetite to go for a second transplant after having a relapse. Some centers, because there was a later relapse, or the kids or adults was in a pretty okay clinical condition. So some of the centers started to do second allotransplants. That’s what we did in the Princess Maxima as well as MSKCC, the center where I’m in now. In the abstract, you are referring to, we have collected the data from these two centers. Yes, it is a relatively selective group of patients because they were all in a pretty okay clinical condition. They all had a relapse more than four, more than six months after transplant so, relatively late. With the data and from a couple of centers that used cord blood as a cell source, you may get better disease control. We decided to transplant these patients only with cord blood because there is data from a couple of centers that even when you are MRD plus before allotransplant, you still are able to get relatively good disease control. In this analysis, 20+, 23 patients, or so, 25 patients, we got an overall survival of 65%, which for a second allotransplant is not bad. That’s pretty okay data. That’s almost similar to the outcomes after the first allotransplant. We think, and we should prove that, of course, obviously in a larger clinical trial that using the cord blood as cell source, that’s the main driver of getting good disease control in a second attempt. What I can tell you more about is dual center analysis from MSK and the Princess Maxima, is that also the non-relapse mortality, so the toxicity is not too bad. Yes, overall in the whole cohort, it was about 20%, but when you look at the most recent cohort, there was no transplant-related mortality since 2015. It’s a good option for pediatric patients, young adult patients who relapse after first allotransplant, who are in a good clinical condition and have a relapse a little bit later on, not very early, within a month or two, using an unrelated cord blood to try to get disease control in a second attempt.
