Outcome of allogeneic bone marrow transplantation for children with advanced acute myeloid leukemia.

Eneida R Nemecek's picture
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TitleOutcome of allogeneic bone marrow transplantation for children with advanced acute myeloid leukemia.
Publication TypeJournal Article
Year of Publication2004
AuthorsNemecek, ER, Gooley, TA, Woolfrey, AE, Carpenter, PA, Matthews, DC, Sanders, JE
JournalBone Marrow Transplant
Volume34
Issue9
Pagination799-806
Date Published2004 Nov
ISSN0268-3369
KeywordsAdolescent, Bone Marrow Transplantation, Child, Child, Preschool, Female, Graft vs Host Disease, Histocompatibility Testing, Humans, Infant, Leukemia, Myeloid, Acute, Male, Recurrence, Retrospective Studies, Survival Analysis, Time Factors, Transplantation, Homologous, Treatment Outcome
Abstract

Allogeneic bone marrow transplantation (BMT) may offer the only chance of cure for children with acute myeloid leukemia (AML) in second complete remission (CR2) or with relapsed disease, but the outcome of these patients has not been clearly defined. We conducted a retrospective study of 58 children, median age 7.4 years (range 0.8-17.3), who received matched related or unrelated BMT at our institution for AML in CR2 (n = 12), in untreated first relapse (n = 11) or with refractory disease (n = 35), to identify risk factors associated with disease-free survival (DFS). Life threatening to fatal regimen-related toxicity was observed in 22% of patients. Estimates of DFS at 5 years (95% confidence interval) for patients in CR2, with untreated first relapse and refractory disease were 58% (27-80%), 36% (11-63%) and 9% (2-21%), respectively. Non-relapse mortality estimates were 0%, 27% (0-54%) and 17% (5-30%), and relapse estimates were 42% (14-70%), 36% (8-65%) and 74% (60-89%), respectively. Advanced disease phase and cytogenetic abnormalities at the time of transplantation were each associated with decreased DFS and increased relapse in multivariable regression models. Survival for children transplanted in CR2 or untreated first relapse is higher than that previously reported, but relapse remains the major cause of treatment failure regardless of disease stage.

DOI10.1038/sj.bmt.1704689
Alternate JournalBone Marrow Transplant.
PubMed ID15361903
PubMed Central IDPMC2926343
Grant ListCA18029 / CA / NCI NIH HHS / United States
CA100394 / CA / NCI NIH HHS / United States
P01 CA018029 / CA / NCI NIH HHS / United States
K23 CA100394 / CA / NCI NIH HHS / United States
K23 CA100394-01 / CA / NCI NIH HHS / United States