Hematopoietic Stem Cell Transplantation in Children with Leukemia: A Single Institution Experience with Respect to Donors.
10.3346/jkms.2011.26.12.1548
- Author:
Hee Jo BAEK
1
;
Hoon KOOK
;
Dong Kyun HAN
;
Tai Ju HWANG
Author Information
1. Department of Pediatrics, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju, Korea.
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Allogeneic Hematopoietic Stem Cell Transplantation;
Leukemia;
Unrelated Donor;
Umbilical Cord Blood
- MeSH:
Adolescent;
Child;
Child, Preschool;
*Cord Blood Stem Cell Transplantation/adverse effects/methods;
Disease-Free Survival;
Female;
Fetal Blood/transplantation;
Graft vs Leukemia Effect;
*Hematopoietic Stem Cell Transplantation/adverse effects/methods/mortality;
Histocompatibility Testing;
Humans;
Infant;
Leukemia/mortality/*therapy;
Male;
Transplantation, Homologous;
Treatment Outcome;
Unrelated Donors
- From:Journal of Korean Medical Science
2011;26(12):1548-1555
- CountryRepublic of Korea
- Language:English
-
Abstract:
Aim of this study was to compare the outcomes of transplantation by donor source and to help select the best alternative donor in children with leukemia. Donor sources included matched related donor (MRD, n = 35), allele-matched unrelated donor (M-UD, n = 10) or -mismatched (MM)-UD (n = 13) or unrelated umbilical cord blood (UCB, n = 11). UCB group had a significantly higher incidence of grade II-IV acute graft versus host disease (MRD, 11.8%; M-UD, 30.0%; MM-UD, 15.4%, UCB, 54.4%, P = 0.004) but there was no difference in incidence of chronic graft versus host disease between 4 groups. The 5-yr leukemia-free survival (LFS) was 76.7%, 60.0%, 69.2%, and 45.5%, respectively (P = 0.128). MRD group showed higher LFS rate than UCB group (P = 0.022). However, LFS of M-UD and MM-UD together (65.2%) was not different from that of MRD group (76.7%, P = 0.325), or from that of UCB (45.5%, P = 0.190). The relapse incidence at 5 yr was 17.1%, 20.0%, 15.4%, and 0%, respectively (P = 0.460). The 100-day treatment-related mortality was 2.9%, 20.0%, 7.7%, and 36.4%, respectively (P = 0.011). Despite the limitations of small number of patients, unrelated donor transplants including even allele-mismatched ones, seem to be as effective in children with leukemia lacking suitable relative donors. Also, UCB transplant may serve as another possible option in urgent transplants.
