Unrelated cord blood stem cell transplantation for high-risk/refractory childhood acute myeloid leukemia: a clinical analysis of 160 cases
10.3760/cma.j.issn.0253-2727.2021.07.004
- VernacularTitle:非血缘脐血干细胞移植治疗高危/难治儿童急性髓系白血病160例临床分析
- Author:
Erling CHEN
1
;
Huilan LIU
;
Liangquan GENG
;
Baolin TANG
;
Xiaoyu ZHU
;
Wen YAO
;
Kaidi SONG
;
Xiang WAN
;
Guangyu SUN
;
Ping QIANG
;
Qian FAN
;
Ziwei ZHOU
;
Changcheng ZHENG
;
Lei ZHANG
;
Xuhan ZHANG
;
Juan TONG
;
Zimin SUN
Author Information
1. 中国科学技术大学附属第一医院（安徽省立医院）血液科，合肥 230001
- Keywords:
Cord blood hematopoietic stem cell transplantation;
Children;
Acute myeloid leukemia
- From:
Chinese Journal of Hematology
2021;42(7):549-554
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To retrospectively analyze the clinical outcomes of single unrelated cord blood transplantation (UCBT) in children with high risk and refractory acute myeloid leukemia (AML) .Methods:Between June 2008 and December 2018, a total of 160 consecutive pediatric patients with AML received single UCBT (excluding acute promyelocytic leukemia) . Myeloablative conditioning (MAC) regimen were applied. All patients received a combination of cyclosporine A (CsA) and mycophenolate mofetil (MMF) for the prophylaxis of graft -versus- host disease (GVHD) .Results:The cumulative incidence of neutrophil cells engraftment at day +42 and platelet recovery at day +120 was 95.0% (95% CI 90.0%-97.5%) at a median of 16 days after transplantation (range, 11-38 days) and 85.5% (95% CI 83.3%-93.4%) with a median time to recovery of 35 days (range, 13-158) , respectively. Incidence of grades Ⅱ-Ⅳ and Ⅲ-Ⅳ acute GVHD and chronic GVHD were 37.3% (95%CI 29.3%-45.2%) , 27.3% (95% CI 20.0%-35.0%) and 22.4% (95% CI 15.5%-28.7%) , respectively. The transplant-related mortality (TRM) at 360 day was 13.1% (95% CI 8.4%-18.9%) . The 5-year cumulative incidence of relapse was 13.8% (95% CI 8.5%-20.3%) . The 5-year disease-free survival (DFS) and overall survival (OS) were 71.7% (95% CI 62.7%-77.8%) and 72.2% (95% CI 64.1%-78.7%) , respectively. The 5-year GVHD and relapse free survival (GRFS) was 56.1% (95% CI 46.1%-64.9%) . The 5-year cumulative recurrence rates of CR1, CR2, and NR groups were 5.3%, 19.9%, and 30.9% ( P=0.001) , and the 5-year OS rates were 79.9% (95% CI 70.3%-86.7%) , 71.1% (95% CI 50.4%-84.4%) and 52.9% (95% CI 33.0%-69.3%) ( χ2=7.552, P=0.020) , respectively. Conclusions:For pediatric patients with high risk and refractory AML, UCBT is a safe and effective treatment option, and it is favorable to improve the survival rate in CR1 stage.
