One Hundred Cases of HLA-matched Sibling Allogeneic bone Marrow Transplantation in Children: Single Center Study.
- Author:
Hack Ki KIM
1
;
Bin CHO
;
Nak Gyun CHUNG
;
Dae Chul JEONG
;
Soh Yeon KIM
;
Hyun Jung LEE
;
Kyong Su LEE
;
Kyung Ja HAN
;
Won Il KIM
;
Il Bong CHOI
;
Chun Choo KIM
Author Information
1. Department of Pediatrics, College of Medicine, The Catholic University of Korea.
- Publication Type:Original Article
- MeSH:
Anemia, Aplastic;
Bone Marrow Transplantation*;
Bone Marrow*;
Child*;
Diagnosis;
Disease-Free Survival;
Female;
Follow-Up Studies;
Humans;
Leukemia, Myelogenous, Chronic, BCR-ABL Positive;
Leukemia, Myeloid, Acute;
Male;
Precursor Cell Lymphoblastic Leukemia-Lymphoma;
Purpura, Thrombotic Thrombocytopenic;
Recurrence;
Siblings*;
Stem Cells
- From:Journal of the Korean Pediatric Society
2000;43(3):402-410
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: We reviewed 100 cases of HLA-matched sibling allogeneic bone marrow transplantation(allo-BMT) in children and wish to share these results. MEHTODS: One hundred children had undergone allo-BMT from HLA-identical siblings between Nov. 1983 and May 1998. There were 50 males and 50 females with a median age of 10 years and a median follow-up of 38 months. Out of 100 cases, 43 children were transplanted for severe aplastic anemia (SAA), 29 for acute myelogenous leukemia (AML), 18 for acute lymphocytic leukemia (ALL), 8 for chronic myelogenous leukemia (CML) and 2 for hemophagocytic lympho-histiocytosis (HLH). RESULTS: SAA : The 5-year event free survival (EFS) of SAA was 91%. The types of events that occurred were 3 thrombotic thrombocytopenic purpura (TTP), 2 venoocclusive disease (VOD) and 1 rejection. AML : In 25 of 29 cases, the 4-year EFS after allogeneic BMT in first remission was 71%. That of the TBI-based and Busulfan-based group was 44% and 77%, respectively. The most favorable results were observed in the Busulfan-based group in first remission with an EFS of 81% (n=18). The types of events that occurred were 4 TTP, 3 VOD, 2 rejections and 1 relapse. ALL : Five-year EFS of children with complete remission (CR; n=14, 7 CR1, 7 CR2) was 81%. CML : For the 6 children who received transplants while in the first chronic phase, the event free survival was 67%. HLH : Both of the two children with HLH survived 9 months and 24 months after BMT, respectively. Acute GVHD (> or =Grade ll) was observed in 13 children. Chronic GVHD developed in 10 children; 8 cases were localized and 2 were extensive type. CONCLUSION: Allo-BMT can cure children with refractory stem cell disorders. The most important factor that influences survival after transplantation is interval between diagnosis and transplantation for patients with severe aplastic anemia and remission state at transplantation for patients with leu-
