Faculty Collaboration Database

Transplantation for children with acute myeloid leukemia: a comparison of outcomes with reduced intensity and myeloablative regimens. Blood 2014 Mar 06;123(10):1615-20

Date

01/18/2014

Pubmed ID

24435046

Pubmed Central ID

PMC3945869

DOI

10.1182/blood-2013-10-535716

Scopus ID

2-s2.0-84897518668 (requires institutional sign-in at Scopus site)   54 Citations

Abstract

The safety and efficacy of reduced-intensity conditioning (RIC) regimens for the treatment of pediatric acute myeloid leukemia is unknown. We compared the outcome of allogeneic hematopoietic cell transplantation in children with acute myeloid leukemia using RIC regimens with those receiving myeloablative-conditioning (MAC) regimens. A total of 180 patients were evaluated (39 with RIC and 141 with MAC regimens). Results of univariate and multivariate analysis showed no significant differences in the rates of acute and chronic graft-versus-host disease, leukemia-free, and overall survival between treatment groups. The 5-year probabilities of overall survival with RIC and MAC regimens were 45% and 48%, respectively (P = .99). Moreover, relapse rates were not higher with RIC compared with MAC regimens (39% vs 39%; P = .95), and recipients of MAC regimens were not at higher risk for transplant-related mortality compared with recipients of RIC regimens (16% vs 16%; P = .73). After carefully controlled analyses, we found that in this relatively modest study population, the data supported a role for RIC regimens for acute myeloid leukemia in children undergoing allogeneic hematopoietic cell transplantation. The data also provided justification for designing a carefully controlled randomized clinical trial that examines the efficacy of regimen intensity in this population.

Author List

Bitan M, He W, Zhang MJ, Abdel-Azim H, Ayas MF, Bielorai B, Carpenter PA, Cairo MS, Diaz MA, Horan JT, Jodele S, Kitko CL, Schultz KR, Kletzel M, Kasow KA, Lehmann LE, Mehta PA, Shah N, Pulsipher MA, Prestidge T, Seber A, Shenoy S, Woolfrey AE, Yu LC, Davies SM

Author

Mei-Jie Zhang PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin

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

Adolescent
Child
Child, Preschool
Female
Hematopoietic Stem Cell Transplantation
Humans
Leukemia, Myeloid, Acute
Male
Transplantation Conditioning
Transplantation, Homologous
Treatment Outcome