Korean Journal of Pediatric Hematology-Oncology  2002;9(2):155-165

Allogeneic Hematopoietic Stem Cell Transplantation in Children with Acute Lymphoblastic Leukemia: Experiences in a Single Center.

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

Affiliations

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Keywords

Acute lymphoblastic leukemia; Hematopoietic stem cell transplantation

Country

Republic 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.