Allogeneic Hematopoietic Stem Cell Transplantation in Children with Acute Lymphoblastic Leukemia: Experiences in a Single Center.
- Author:
Ki Woong SUNG
1
;
Keon Hee YOO
;
Eun Hee CHUNG
;
Chang Kyu KANG
;
Bong Lim KIM
;
Kwang Bin MOON
;
Jong Hee HWANG
;
Hong Hoe KOO
;
Do Hoon LIM
;
Quehn PARK
;
Sun Hee KIM
;
Dae Won KIM
;
Hye Kyung PARK
Author Information
1. Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. kwsped@samsung.co.kr
- Publication Type:Original Article
- Keywords:
Acute lymphoblastic leukemia;
Hematopoietic stem cell transplantation
- MeSH:
Child;
Cyclophosphamide;
Cyclosporine;
Disease-Free Survival;
Follow-Up Studies;
Hematopoietic Stem Cell Transplantation*;
Hematopoietic Stem Cells*;
Humans;
Methotrexate;
Methylprednisolone;
Precursor Cell Lymphoblastic Leukemia-Lymphoma*;
Recurrence;
Stem Cell Transplantation;
Tissue Donors;
Whole-Body Irradiation
- From:Korean Journal of Pediatric Hematology-Oncology
2002;9(2):155-165
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To improve survival of children with acute lymphoblastic leukemia (ALL), allogeneic hematopoietc stem cell transplantation (HSCT) was applied. METHODS: From June 1999 to May 2002, 27 children with ALL received allogeneic HSCT at Samsung Medical Center. Patients in complete remission (CR) who received HLA-matched HSCT before relapse when HSCT was indicated were assigned to standard-risk, otherwise were assigned to high-risk. Cyclophosphamide and total body irradiation was basic conditioning regimen. For prophylaxis of GVHD, cyclosporine alone in related HSCT and cyclosporine methotrexate methylprednisolone in unrelated HSCT were used. RESULTS: Fifteen patients in first CR including 6 induction failures, 3 MLL rearrangements and 2 Philadelphia chromosomes, and 3 patients in second CR were assigned to standard-risk. Thirteen related HLA-matched, 11 unrelated HLA-matched, 2 related HLA-mismatched and 1 unrelated HLA-mismatched HSCT were applied. Sixteen of 18 standard-risk patients are still alive with median follow-up of 12.5 (range: 2~37) months and 13 of them are disease-free without relapse. Event-free survival rate (EFS) in 18 standard-risk and 9 high-risk patients were 68.2% and 14.8%, respectively. Confined to standard-risk patients, EFS in related and unrelated HSCT were 75.0%, 60.0%, respectively. CONCLUSION: When allogeneic HSCT is indicated in childhood ALL with available HLA-matched donor, early transplantation before clinical aggravation seems to be necessary.
