Korean J Pediatr Hematol Oncol.  2002 Oct;9(2):155-165.

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

Affiliations
  • 1Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. kwsped@samsung.co.kr
  • 2Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 3Department of Clinical Pathology Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 4Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

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.

Keyword

Acute lymphoblastic leukemia; Hematopoietic stem cell transplantation

MeSH Terms

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
Cyclophosphamide
Cyclosporine
Methotrexate
Methylprednisolone
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