Transplantation for Children with Acute Myeloid Leukemia: a Comparison of Outcomes with Reduced Intensity and Myeloablative Regimens

Overview

Journal Blood

Publisher Elsevier

Specialty Hematology

Date 2014 Jan 18

PMID 24435046

Citations 24

Authors

Menachem Bitan

Wensheng He

Mei-Jie Zhang

Hisham Abdel-Azim

Mouhab Fakhreddine Ayas

Bella Bielorai

Paul A Carpenter

Mitchell S Cairo

Miguel Angel Diaz

John T Horan

Sonata Jodele

Carrie L Kitko

Kirk R Schultz

Morris Kletzel

Kimberly A Kasow

Leslie E Lehmann

Parinda A Mehta

Nirali Shah

Michael A Pulsipher

Tim Prestidge

Adriana Seber

Shalini Shenoy

Ann E Woolfrey

Lolie C Yu

Stella M Davies

Affiliations

Soon will be listed here.

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.

Citing Articles

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[Chinese expert consensus of the allogeneic hematopoietic stem cell transplantation for pediatric acute myeloid leukemia (not APL) (2022)].

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