Clin Pediatr Hematol Oncol.  2016 Oct;23(2):145-157. 10.15264/cpho.2016.23.2.145.

Outcomes of Hematopoietic Stem Cell Transplantation by Donor Types in Children with Acute Myeloid Leukemia

• Choe HY
• Kim G
• Lee WJ
• Choi JS
• Baek HJ
• Kook H

• KMID: 2358370
• DOI: http://doi.org/10.15264/cpho.2016.23.2.145

Abstract

BACKGROUND
The aim of this study was to compare the outcomes of children with acute myeloid leukemia (AML) who received stem cell transplantation from different donor groups.
METHODS
This study included 37 pediatric AML patients who received allogeneic stem cell transplantation from March 1996 to December 2012 at Chonnam National University Hospital and Chonnam National University Hwasun Hospital. The overall survival (OS), event-free survival (EFS), cumulative incidence (CI) of graft versus host disease (GvHD), relapse and transplant-related mortality (TRM) were compared between different donor groups.
RESULTS
Transplant donor groups included matched sibling donor (MSD, n=15), unrelated donor (URD=13), unrelated umbilical cord blood (UCB, n=7), or haploidentical donor (HD, n=2). Twenty-six patients survived with a median follow-up of 7.3 years. The 7-year EFS rates were 80.0±10.3% in MSD, 69.2±12.8% in URD and 57.1±18.7% in UCB, and 0% in HD, respectively (P=0.019). The CI of relapse at 5 years was 20.0%, 15.4%, 33.3%, 50%, respectively (P=0.721). The CI of TRM at 2 years was 0%, 15.4%, 16.7%, 50.0%, respectively in each donor group (P=0.017). The CI of grade II-IV acute and extensive chronic GvHD were higher in UCB (P=0.003, P=0.020, respectively). There were no significant differences in OS, EFS, and CI of TRM and relapse between allele-mismatched URD and UCB.
CONCLUSION
Despite the limitation of small number of patients, the comparable outcome of pediatric AML patients transplanted from alternative donor with those transplanted from MSD are encouraging. Especially, if a matched donor is not available, allele-mismatched URD or UCB transplant may offer the advantage of prompt availability for patients who urgently require transplantation.

Keyword

Acute myeloid leukemia; Stem cell transplantation; Children

MeSH Terms

Child*
Disease-Free Survival
Fetal Blood
Follow-Up Studies
Graft vs Host Disease
Hematopoietic Stem Cell Transplantation*
Hematopoietic Stem Cells*
Humans
Incidence
Jeollanam-do
Leukemia, Myeloid, Acute*
Mortality
Recurrence
Siblings
Stem Cell Transplantation
Tissue Donors
Unrelated Donors