Outcomes of Hematopoietic Stem Cell Transplantation by Donor Types in Children with Acute Myeloid Leukemia
10.15264/cpho.2016.23.2.145
- Author:
Ha Yeong CHOE
1
;
Gun KIM
;
Woo Jin LEE
;
Joon Sik CHOI
;
Hee Jo BAEK
;
Hoon KOOK
Author Information
1. Department of Pediatrics, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea. pe00069@jnu.ac.kr
- Publication Type:Original Article
- Keywords:
Acute myeloid leukemia;
Stem cell transplantation;
Children
- MeSH:
Child;
Disease-Free Survival;
Fetal Blood;
Follow-Up Studies;
Graft vs Host Disease;
Hematopoietic Stem Cell Transplantation;
Hematopoietic Stem Cells;
Humans;
Incidence;
Jeollanam-do;
Leukemia, Myeloid, Acute;
Mortality;
Recurrence;
Siblings;
Stem Cell Transplantation;
Tissue Donors;
Unrelated Donors
- From:Clinical Pediatric Hematology-Oncology
2016;23(2):145-157
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: The aim of this study was to compare the outcomes of children with acute myeloid leukemia (AML) who received stem cell transplantation from different donor groups.METHODS: This study included 37 pediatric AML patients who received allogeneic stem cell transplantation from March 1996 to December 2012 at Chonnam National University Hospital and Chonnam National University Hwasun Hospital. The overall survival (OS), event-free survival (EFS), cumulative incidence (CI) of graft versus host disease (GvHD), relapse and transplant-related mortality (TRM) were compared between different donor groups.RESULTS: Transplant donor groups included matched sibling donor (MSD, n=15), unrelated donor (URD=13), unrelated umbilical cord blood (UCB, n=7), or haploidentical donor (HD, n=2). Twenty-six patients survived with a median follow-up of 7.3 years. The 7-year EFS rates were 80.0±10.3% in MSD, 69.2±12.8% in URD and 57.1±18.7% in UCB, and 0% in HD, respectively (P=0.019). The CI of relapse at 5 years was 20.0%, 15.4%, 33.3%, 50%, respectively (P=0.721). The CI of TRM at 2 years was 0%, 15.4%, 16.7%, 50.0%, respectively in each donor group (P=0.017). The CI of grade II-IV acute and extensive chronic GvHD were higher in UCB (P=0.003, P=0.020, respectively). There were no significant differences in OS, EFS, and CI of TRM and relapse between allele-mismatched URD and UCB.CONCLUSION: Despite the limitation of small number of patients, the comparable outcome of pediatric AML patients transplanted from alternative donor with those transplanted from MSD are encouraging. Especially, if a matched donor is not available, allele-mismatched URD or UCB transplant may offer the advantage of prompt availability for patients who urgently require transplantation.
