Results of hemopoietic cell transplantation in the first complete remission in children with acute myeloid leukemia from an intermediate risk group


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Abstract

Aim. To analyze the results of allogeneic and autologous hemopoietic cell transplantations (allo- and auto-HCT) in children with acute myeloid leukemia (AML) from an intermediate risk group, most of which were performed using lower-intensity conditioning modes.
Subjects and methods. The study enrolled 36 children from an intermediate risk group, who had undergone auto-HCT (n = 22) or allo-HCT (n = 14) in December 1994 to December 2008. The patients' age was 0.7 to 16.6 years (median 12.8 years). Chemotherapeutic conditioning regimens were applied to all the patients. Melphalan was a basic myeloablative agent in 83.3% of cases.
Results. With a median follow-up of 4.6 years (1.1-13.8 years), three-year relapse-free survival (RFS) was 80.4%; overall survival (OS) was 65.6%. Recurrences were documented only in 6 (16.6%) patients from the auto-HCT. Transplantation-associated mortality (TAM) was 13.8% (five patients died). After allo-HCT versus auto-HCT, RFS, OS, and TAM were 100 and 68.7% (p = 0.03), 93.2 and 55.5% (p = 0.02), and 7.1 and 18.2%, respectively. Acute and chronic graft-versus-host reactions developed in 57.1 and 23.1%, respectively.
Conclusion. Transplantation of allogeneic hemopoietic cells from a compatible related donor in the intermediate risk group children with AML, by using melphalan-based conditioning regimen, demonstrates a high survival rate with the minimum toxicity.

About the authors

Z M Dyshlevaya

Russian Children's Hospital, Moscow

Russian Children's Hospital, Moscow

E V Skorobogatova

Russian Children's Hospital, Moscow

Russian Children's Hospital, Moscow

M A Maschan

Federal Research and Clinical Centre of Pediatric Hematology, Oncology and Immunology, Ministry of Health of the Russian Federation

Federal Research and Clinical Centre of Pediatric Hematology, Oncology and Immunology, Ministry of Health of the Russian Federation

I P Shipitsyna

Russian Children's Hospital, Moscow

Russian Children's Hospital, Moscow

Yu V Skvortsova

Russian Children's Hospital, Moscow

Russian Children's Hospital, Moscow

P E Trakhtman

Russian Children's Hospital, Moscow

Russian Children's Hospital, Moscow

D N Balashov

Russian Children's Hospital, Moscow

Russian Children's Hospital, Moscow

Yu V Pashko

Russian Children's Hospital, Moscow

Russian Children's Hospital, Moscow

E E Kurnikova

Russian Children's Hospital, Moscow

Russian Children's Hospital, Moscow

E V Suntsova

Russian Children's Hospital, Moscow

Russian Children's Hospital, Moscow

O V Goronkova

Russian Children's Hospital, Moscow

Russian Children's Hospital, Moscow

G G Solopova

Russian Children's Hospital, Moscow

Russian Children's Hospital, Moscow

D D Baidildina

Russian Children's Hospital, Moscow

Russian Children's Hospital, Moscow

I I Kalinina

Russian Children's Hospital, Moscow

Russian Children's Hospital, Moscow

L A Khachatryan

Russian Children's Hospital, Moscow

Russian Children's Hospital, Moscow

M M Shneider

Federal Research and Clinical Centre of Pediatric Hematology, Oncology and Immunology, Ministry of Health of the Russian Federation

Federal Research and Clinical Centre of Pediatric Hematology, Oncology and Immunology, Ministry of Health of the Russian Federation

A A Maschan

Federal Research and Clinical Centre of Pediatric Hematology, Oncology and Immunology, Ministry of Health of the Russian Federation

Federal Research and Clinical Centre of Pediatric Hematology, Oncology and Immunology, Ministry of Health of the Russian Federation

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