BACKGROUND: Hematopoietic stem cell transplantation (HSCT) has been established as a promising treatment in acute myeloid leukaemia (AML). Several studies have been performed to minimize the toxicity of HSCT in children without impairing the efficacy. We report our long-term results of HSCT in pediatric AML patients using non-total body irradiation conditioning regimen. PROCEDURE: From May 1991 to June 2010, 133 pediatric patients with AML (age<15 y) who were referred to our institute underwent autologous (auto-) or allogeneic (allo-) HSCT. The conditioning regimen consisted of oral busulfan plus etoposide in auto-HSCT patients and oral busulfan plus cyclophosphamide in allo-HSCT patients. RESULTS: Overall survival (OS), leukemia-free survival (LFS), probability of relapse, and transplantation-related mortality at 3 years were 67.6%, 62.2.5%, 27.3%, and 10.1%, respectively. There was no significant difference between allo-HSCT and auto-HSCT groups. In multivariable analysis using Cox proportional hazards regression model, male sex was associated with significantly improved OS (P<0.001) and LFS (P=0.022). An age ≤3 years was associated with higher relapse (P=0.034) and worse OS (P=0.001) and LFS (P=0.014). CONCLUSIONS: The role of allo-HSCT in pediatric AML patients in first complete remission is uncertain. Further randomized studies are recommended to clarify the optimal postremission therapy in these patients.
BACKGROUND: Hematopoietic stem cell transplantation (HSCT) has been established as a promising treatment in acute myeloid leukaemia (AML). Several studies have been performed to minimize the toxicity of HSCT in children without impairing the efficacy. We report our long-term results of HSCT in pediatric AMLpatients using non-total body irradiation conditioning regimen. PROCEDURE: From May 1991 to June 2010, 133 pediatric patients with AML (age<15 y) who were referred to our institute underwent autologous (auto-) or allogeneic (allo-) HSCT. The conditioning regimen consisted of oral busulfan plus etoposide in auto-HSCT patients and oral busulfan plus cyclophosphamide in allo-HSCT patients. RESULTS: Overall survival (OS), leukemia-free survival (LFS), probability of relapse, and transplantation-related mortality at 3 years were 67.6%, 62.2.5%, 27.3%, and 10.1%, respectively. There was no significant difference between allo-HSCT and auto-HSCT groups. In multivariable analysis using Cox proportional hazards regression model, male sex was associated with significantly improved OS (P<0.001) and LFS (P=0.022). An age ≤3 years was associated with higher relapse (P=0.034) and worse OS (P=0.001) and LFS (P=0.014). CONCLUSIONS: The role of allo-HSCT in pediatric AMLpatients in first complete remission is uncertain. Further randomized studies are recommended to clarify the optimal postremission therapy in these patients.
Authors: A A Hamidieh; M Ostadali Dehaghi; P Paragomi; S Navaei; A Jalali; G Ghazizadeh Eslami; M Behfar; A Ghavamzadeh Journal: Bone Marrow Transplant Date: 2015-01-26 Impact factor: 5.483
Authors: L Zhang; A Samad; M S Pombo-de-Oliveira; G Scelo; M T Smith; J Feusner; J L Wiemels; C Metayer Journal: Blood Rev Date: 2014-09-30 Impact factor: 8.250
Authors: A A Hamidieh; M Behfar; A E S Babaki; A Jalali; A-S Hosseini; M Jahani; K Alimoghaddam; A Ghavamzadeh Journal: Bone Marrow Transplant Date: 2015-01-19 Impact factor: 5.483
Authors: Nathan J Rodgers; Alexander M Kaizer; Weston P Miller; Kyle D Rudser; Paul J Orchard; Elizabeth A Braunlin Journal: J Inherit Metab Dis Date: 2017-01-04 Impact factor: 4.982