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Alternative donor bone marrow transplant for children with Philadelphia chromosome ALL. Bone Marrow Transplant 2006 Jan;37(2):135-41

Date

11/08/2005

Pubmed ID

16273115

DOI

10.1038/sj.bmt.1705200

Scopus ID

2-s2.0-30944438521   14 Citations

Abstract

Children with Philadelphia chromosome positive (Ph+) acute lymphocytic leukemia (ALL) have only a 20% event-free survival when treated with chemotherapy alone. Bone marrow transplant (BMT) for patients with matched siblings has been associated with significantly better long-term survival. We asked whether children who lack a matched sibling donor would do as well if an alternative donor was utilized. Between 1987 and 2002, we transplanted 29 children and adolescents using either an unrelated donor (23) or a mismatched family member (six). The conditioning regimen included cytosine-arabinoside, cyclophosphamide and total body irradiation. Graft-versus-host disease (GVHD) prophylaxis consisted of T-cell depletion (antibody T10B9 or OKT3 and complement) with post transplant cyclosporine (CSA). All patients engrafted. Four developed grades III-IV acute GVHD. Three of 24 evaluable patients developed extensive chronic GVHD. Two patients died of relapse (7%). Two long-term survivors (>6 years) died of malignant glioblastoma multiforme. Event-free survival at 3, 5, and 10 years is 56, 51, and 46%, respectively. Five of six patients in >CR2 or relapse at the time of transplant died. Our data should encourage the use of alternative donor transplants early in the course of disease for children with Ph+ ALL.

Author List

Talano JM, Casper JT, Camitta BM, Keever-Taylor CA, Murray KJ, Eapen M, Pierce KL, Margolis DA

Authors

Bruce M. Camitta MD Adjunct 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
David A. Margolis MD Interim Chair, Professor in the Pediatrics department at Medical College of Wisconsin
Julie-An M. Talano MD Professor in the Pediatrics department at Medical College of Wisconsin




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

Adolescent
Adult
Bone Marrow Transplantation
Child
Child, Preschool
Cyclophosphamide
Cytarabine
Disease-Free Survival
Donor Selection
Female
Glioblastoma
Graft vs Host Disease
Humans
Immunosuppressive Agents
Lymphocyte Depletion
Male
Neoplasms, Second Primary
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Prognosis
Recurrence
Retrospective Studies
Transplantation Conditioning
Whole-Body Irradiation