Clin Pediatr Hematol Oncol.  2007 Oct;14(2):159-166.

Comparative Results of Autologous Hematopoietic Stem Cell Transplantation in Childhood Acute Myeloid Leukemia Patients with Continuous Complete Remission during Consolidation Chemotherapy

• Choi SY
• Kim NK
• Kwon SY
• Han JW
• Won SC
• Lyu CJ

Abstract

PURPOSE: In many studies, allogeneic hematopoietic stem cell transplantation (Allo-HSCT) is the most effective treatment of acute myeloid leukemia (AML). Autologous hematopoietic stem cell transplantation (Auto-HSCT) is another choice of treatment in patients who do not have an HLA matched donor. But overall results comparing Auto-HSCT to Allo-HSCT and chemotherapy only have been inconsistent. We report the results of Auto-HSCT in childhood AML patients.
METHODS
From the retrospectively maintained database at the Pediatric Department of Severance Hospital, we identified patients less than 15 years of age. They achieved remission and continuous complete remission during consolidation chemotherapy. They were treated with Auto-HSCT, Allo-HSCT or chemotherapy only. Event-free-survival (EFS) rates were estimated by the method of Kaplan and Meier, and confidence intervals were calculated using log-rank test.
RESULTS
16 children with AML who achieved remission and continuous complete remission during consolidation chemotherapy were selected. They were eligible for allocation to Allo-HSCT (n=7) or to Auto-HSCT (n=5) or chemotherapy only (n=4). EFS of 3 years is as follows: Allo-HSCT, 71.4%+/-17.1%; Auto-HSCT, 100%; and chemotherapy only, 25%+/-22%. EFS in Auto-HSCT is significantly superior to chemotherapy only (P=0.04). Differences between Auto-HSCT and Allo-HSCT are not significant (P=0.21).
CONCLUSION
When patients with AML who achieved remission and continuous complete remission during consolidation chemotherapy had no HLA matched donor, Auto-HSCT was a more effective therapy than chemotherapy only and had similar effectiveness with Allo-HSCT.

Keyword

Acute myeloid leukemia; Autologous stem cell transplantation; Childhood

MeSH Terms

Child
Consolidation Chemotherapy*
Drug Therapy
Hematopoietic Stem Cell Transplantation*
Hematopoietic Stem Cells*
Humans
Leukemia, Myeloid, Acute*
Retrospective Studies
Tissue Donors