Faculty Collaboration Database

Allogeneic hematopoietic cell transplantation in first remission abrogates poor outcomes associated with high-risk pediatric acute myeloid leukemia. Biol Blood Marrow Transplant 2013 Jul;19(7):1021-5

Date

04/10/2013

Pubmed ID

23567175

Pubmed Central ID

PMC3712759

DOI

10.1016/j.bbmt.2013.04.001

Scopus ID

2-s2.0-84879339630 (requires institutional sign-in at Scopus site)   23 Citations

Abstract

Despite remission rates of approximately 85% for children diagnosed with acute myeloid leukemia (AML), greater than 40% will die from relapsed disease. Patients with poor-risk molecular/cytogenetics and/or inadequate response to up-front therapy are typically considered high-risk (HR) and historically have poor outcomes with chemotherapy alone. We investigated whether allogeneic hematopoietic cell transplantation (allo-HCT) with best available donor in first remission (CR1) would abrogate the poor outcomes associated with HR AML in children and young adults treated with chemotherapy. We reviewed the outcomes of 50 consecutive children and young adults (ages 0 to 30 years) with AML who received a myeloablative allo-HCT between 2001 and 2010. Thirty-six patients (72%) were HR, defined as having FLT3-ITD mutations, 11q23 MLL rearrangements, chromosome 5 or 7 abnormalities, induction failure, and/or having persistent disease. The majority of patients received cyclophosphamide and total body irradiation conditioning, and graft-versus-host-disease (GVHD) prophylaxis was cyclosporine based. Transplantation outcomes for HR patients were compared to standard-risk patients, with no significant differences observed in overall survival (72% versus 78%, P = .72), leukemia-free survival (69% versus 79%, P = .62), relapse (11% versus 7%, P = .71), or treatment-related mortality (17% versus 14%, P = .89). Children and young adults with HR-AML have comparable outcomes to standard-risk patients following allo-HCT in CR1.

Author List

Burke MJ, Wagner JE, Cao Q, Ustun C, Verneris MR

Author

Michael James Burke MD Professor in the Pediatrics department at Medical College of Wisconsin

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

Adolescent
Adult
Child
Child, Preschool
Chromosome Aberrations
Chromosomes, Human, Pair 5
Chromosomes, Human, Pair 7
Female
Hematopoietic Stem Cell Transplantation
Humans
Infant
Leukemia, Myeloid, Acute
Male
Mutation
Myeloablative Agonists
Oncogene Proteins, Fusion
Prognosis
Recurrence
Remission Induction
Risk
Survival Analysis
Transplantation Conditioning
Transplantation, Homologous