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Autologous hematopoietic stem-cell transplantation for children with acute myeloid leukemia in first or second complete remission: a prognostic factor analysis. J Clin Oncol 2004 Sep 15;22(18):3798-804 PMID: 15365077

Pubmed ID

15365077

Abstract

PURPOSE: To determine prognostic factors correlated with outcomes after autologous hematopoietic stem-cell transplantation (HSCT) in children with acute myeloid leukemia (AML).

PATIENTS AND METHODS: We studied 219 children who received autologous HSCT for AML in first complete remission (CR) and 73 children in second CR and who were reported to the Autologous Blood and Marrow Transplant Registry. Among 29 of 73 patients who underwent transplantation in second CR, duration of first CR was > or = 12 months.

RESULTS: Three-year cumulative incidences of relapse were 37% (95% CI, 31% to 44%), 60% (95% CI, 41% to 74%), and 36% (95% CI, 20% to 53%) for children in first CR, second CR after a short (< 12 months) first CR, and second CR after a long (> or = 12 months) first CR, respectively. Corresponding 3-year probabilities of leukemia-free survival were 54% (95% CI, 47% to 60%), 23% (95% CI, 10% to 39%), and 60% (95% CI, 42% to 75%). In multivariate analyses, risks of relapse, mortality, and treatment failure (relapse or death, inverse of leukemia-free survival) were higher for patients in second CR after a short first CR than for the other two groups. Transplant-related mortality, treatment failure, and overall mortality rates were higher in older (> 10 years) children.

CONCLUSION: Duration of first CR seems to be the most important determinant of outcome. Results in children who experience treatment failure with conventional chemotherapy support the use of autologous transplantation as salvage therapy if such patients achieve a subsequent CR.

Author List

Godder K, Eapen M, Laver JH, Zhang MJ, Camitta BM, Wayne AS, Gale RP, Doyle JJ, Yu LC, Chen AR, Garvin JH Jr, Sandler ES, Yeager AM, Edwards JR, Horowitz MM

Authors

Bruce M. Camitta MD Clinical Professor in the Medicine department at Medical College of Wisconsin
Mary Eapen MBBS, DCh, MRCPI, MS Professor in the Medicine department at Medical College of Wisconsin
Mary M. Horowitz MD, MS Center Director, Professor in the Medicine department at Medical College of Wisconsin
Mei-Jie Zhang PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin




Scopus

2-s2.0-4644343739   16 Citations

MESH terms used to index this publication - Major topics in bold

Acute Disease
Adolescent
Adult
Child
Child, Preschool
Disease-Free Survival
Female
Hematopoietic Stem Cell Transplantation
Humans
Infant
Leukemia, Myeloid
Male
Mortality
Prognosis
Recurrence
Retrospective Studies
Treatment Outcome
jenkins-FCD Prod-296 4db9d02597e0a2e889e230f853b641c12f1c3ee3