Efficacy of allogeneic hematopoietic stem cell transplantation in treatment of childhood myelogenous leukemia: the observation of 24 cases.
- Author:
Yuan SUN
1
;
Rui-juan SUN
;
Zhi-jie WEI
;
Juan XIAO
;
Yao-chen ZHANG
;
Yan-qun GAO
;
Hui-li ZHU
Author Information
- Publication Type:Journal Article
- MeSH: Adolescent; Antineoplastic Combined Chemotherapy Protocols; therapeutic use; Child; Child, Preschool; Cyclophosphamide; administration & dosage; Female; Graft vs Host Disease; mortality; prevention & control; Hematopoietic Stem Cell Transplantation; adverse effects; methods; Humans; Leukemia, Myelogenous, Chronic, BCR-ABL Positive; mortality; therapy; Male; Methotrexate; administration & dosage; Retrospective Studies; Survival Analysis; Transplantation Conditioning; methods; Transplantation, Homologous; Treatment Outcome
- From: Chinese Journal of Pediatrics 2012;50(11):813-816
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo retrospectively analyze the effects of allogeneic hematopoietic stem cell transplantation (allo-HSCT) on childhood chronic myelogenous leukemia (CML).
METHODOf the 24 consecutive cases, 16 were boys and 8 were girls. The median age of patients was 12 (3 - 16) years old; 16 cases were in chronic phase (CP) of CML, 1 case in accelerated phase (AP) and 5 cases in blastic phase (BP). Allo-HSCT from HLA identical siblings were performed for 5 cases, HLA haplotype was performed for 14 cases and unrelated allo-HSCT for 5 cases. Twenty-four cases underwent allo-HSCT with conditioning regimen of BUCY. Prophylaxis of graft versus host disease (GVHD) included CsA + MTX plus MMF. The average follow-up was 36 months.
RESULTAll of patients were successfully engrafted. The 5-year overall survival (OS) of the 24 cases was 81%. Four patients died after allo-HSCT including 3 cases in BP from haploidentical donors and 1 case in CP from HLA identical sibling. The 5 cases who received unrelated allo-HSCT have been alive. Among the 10 cases who survived over 5 years, 3 had chronic GVHD.
CONCLUSIONChildren with CML could be treated effectively with allo-HSCT. There were no significant differences among different donors. Transplantation to children with CML should be performed as early as possible. Preparative regimen adjustment before transplantation, the transplantation of associated comorbidities and effective prevention and treatment for CML patients after prolonged graft survival of high quality have important significance.