Korean J Pediatr.  2008 Jan;51(1):67-72. 10.3345/kjp.2008.51.1.67.

Clinical outcomes of hematopoietic stem cell transplantation from HLA-matched parental donor in childhood acute leukemia

• Cha EY
• Lee MH
• Lee JW
• Kwon YJ
• Lee DH
• Park YS
• Chung NG
• Jeong DC
• Cho B
• Kim HK

• KMID: 1487161
• DOI: http://doi.org/10.3345/kjp.2008.51.1.67

Abstract

PURPOSE: In this study, we retrospectively analyzed the clinical outcomes of patients who underwent allogeneic hematopoietic stem cell transplantation (HSCT) grafted from HLA-matched parents.
METHODS
Seven children with acute leukemia (4 acute lymphoblastic leukemia, 3 acute myeloid leukemia) in first complete remission received allogeneic HSCT from their respective parents at the St. Marys Hospital between April, 1999 and October, 2005. The median age of patients at transplantation was 5 years (range, 1-11 years; 2 male, 5 female) and the median age of donors was 35 years (range, 30-41 years; 5 male, 2 female). We investigated the clinical outcomes such as engraftment, acute and chronic graft-versus-host disease (GVHD), transplant-related morbidity and mortality, relapse and survival.
RESULTS
Median time from transplantation to last follow-up was 69.5 months (range, 18.8-96.5 months). All patients were successfully engrafted, with a median time of 11 days (range, 10-16 days) and 26 days (range, 13-39 days) for neutrophil and platelet recovery, respectively. Grade II acute GVHD occurred in 3, and grade III acute GVHD in 1 of 7 recipients. Extensive chronic GVHD developed in 2, and limited chronic GVHD in 1 of 7 recipients. Death from transplant-related complications occurred in 1, and relapse occurred in 1 of 7 recipients. Estimated 5-year overall survival was 83+/-15%.
CONCLUSION
The clinical outcomes of recipients who underwent HSCT from HLA-matched parents were comparable to those of patients who received HSCT grafted from HLA-matched sibling donors in childhood leukemia. HLA typing of parents, as well as siblings will increase the likelihood of finding an HLA-matched family donor for patients who need HSCT.

Keyword

Acute leukemia; Hematopoietic stem cell transplantation; HLA-matched parent

MeSH Terms

Blood Platelets
Child
Follow-Up Studies
Graft vs Host Disease
Hematopoietic Stem Cell Transplantation
Hematopoietic Stem Cells
Histocompatibility Testing
Humans
Leukemia
Male
Neutrophils
Parents
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Recurrence
Retrospective Studies
Siblings
Tissue Donors
Transplants