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Impact of Conditioning Regimen on Outcomes for Children with Acute Myeloid Leukemia Undergoing Transplantation in First Complete Remission. An Analysis on Behalf of the Pediatric Disease Working Party of the European Group for Blood and Marrow Transplantation
G. Lucchini, M. Labopin, E. Beohou, A. Dalissier, JH. Dalle, J. Cornish, M. Zecca, S. Samarasinghe, B. Gibson, F. Locatelli, Y. Bertrand, F. Abdel-Rahman, G. Socie, M. Sundin, A. Lankester, P. Sedlacek, RM. Hamladji, C. Heilmann, B. Afanasyev, R....
Jazyk angličtina Země Spojené státy americké
Typ dokumentu časopisecké články, multicentrická studie
- MeSH
- akutní myeloidní leukemie mortalita terapie MeSH
- analýza přežití MeSH
- busulfan aplikace a dávkování MeSH
- celotělové ozáření MeSH
- cyklofosfamid aplikace a dávkování MeSH
- dítě MeSH
- homologní transplantace MeSH
- indukce remise MeSH
- lidé MeSH
- melfalan aplikace a dávkování MeSH
- mladiství MeSH
- nemoc štěpu proti hostiteli etiologie MeSH
- předškolní dítě MeSH
- příprava pacienta k transplantaci metody mortalita MeSH
- protokoly protinádorové kombinované chemoterapie terapeutické užití MeSH
- recidiva MeSH
- registrace MeSH
- retrospektivní studie MeSH
- transplantace hematopoetických kmenových buněk škodlivé účinky metody MeSH
- výsledek terapie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- Geografické názvy
- Evropa MeSH
Hematopoietic stem cell transplantation (HSCT) represents the cornerstone of treatment in pediatric high-risk and relapsed acute myeloid leukemia (AML). The aim of the present study was to compare outcomes of pediatric patients with AML undergoing HSCT using 3 different conditioning regimens: total body irradiation (TBI) and cyclophosphamide (Cy); busulfan (Bu) and Cy; or Bu, Cy, and melphalan (Mel). In this retrospective study, registry data for patients > 2 and <18 years age undergoing matched allogeneic HSCT for AML in first complete remission (CR1) in 204 European Group for Blood and Marrow Transplantation centers between 2000 and 2010 were analyzed. Data were available for 631 patients; 458 patients received stem cells from a matched sibling donor and 173 from a matched unrelated donor. For 440 patients, bone marrow was used as stem cell source, and 191 patients received peripheral blood stem cells. One hundred nine patients received TBICy, 389 received BuCy, and 133 received BuCyMel as their preparatory regimen. Median follow-up was 55 months. Patients receiving BuCyMel showed a lower incidence of relapse at 5 years (14.7% versus 31.5% in BuCy versus 30% in TBICy, P < .01) and higher overall survival (OS) (76.6% versus 64% versus 64.5%, P = .04) and leukemia-free survival (LFS) (74.5% versus 58% versus 61.9%, P < .01), with a comparable nonrelapse mortality (NRM) (10.8% versus 10.5% versus 8.1%, P = .79). Acute graft-versus-host disease (GVHD) grades III and IV but not chronic GVHD, was higher in patients receiving BuCyMel. Older age at HSCT had an adverse impact on NRM and the use of peripheral blood as stem cell source was associated with increased chronic GVHD and NRM as well as lower LFS and OS. Among pediatric patients receiving HSCT for AML in CR1, the use of BuCyMel conditioning proved superior to TBICy and BuCy in reducing relapse and improving LFS.
Bone Marrow and Stem Cell Transplantation Department King Hussein Cancer Centre Amman Jordan
Bone Marrow Transplant Department Great Ormond Street Hospital London United Kingdom
Haematology Department Royal Hospital for Sick Children Glasgow United Kingdom
Hemato immunology Department Hôpital Robert Debre Paris France
Hematology Department Centre Pierre et Marie Curie Alger Algeria
Hematology Transplantation Department Hôpital St Louis Paris France
Paediatric Haematology and Oncology Department University Hospital Motol Prague Czech Republic
Paediatrics and Adolescent Medicine Department Rigshospitalet Copenhagen Denmark
Pediatric Hematology Oncology Department Fondazione IRCCS Policlinico San Matteo Pavia Italy
Pediatric Hematology Oncology Department IRCCS Bambino Gesu' Children Hospital Rome Italy
Stem Cell Transplantation Department St Anna Kinderspital Vienna Austria
Stem Cell Transplantation Department University College Hospital London United Kingdom
Citace poskytuje Crossref.org
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