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Hematopoietic stem cell transplantation for children with high-risk acute lymphoblastic leukemia in first complete remission: a report from the AIEOP registry.
- Source :
-
Haematologica [Haematologica] 2013 Aug; Vol. 98 (8), pp. 1273-81. Date of Electronic Publication: 2013 Feb 26. - Publication Year :
- 2013
-
Abstract
- Children with high-risk acute lymphoblastic leukemia in first complete remission can benefit from allogeneic hematopoietic stem cell transplantation. We analyzed the outcome of 211 children with high-risk acute lymphoblastic leukemia in first complete remission who were given an allogeneic transplant between 1990 and 2008; the outcome of patients who, despite having an indication for transplantation and a suitable donor, did not receive the allograft for different reasons in the same time period was not analyzed. Sixty-nine patients (33%) were transplanted between 1990 and 1999, 58 (27%) between 2000 and 2005, and 84 (40%) between 2005 and 2008. A matched family donor was employed in 138 patients (65%) and an unrelated donor in 73 (35%). The 10-year probabilities of overall and disease-free survival were 63.4% and 61%, respectively. The 10-year cumulative incidences of transplantation-related mortality and relapse were 15% and 24%, respectively. After 1999, no differences in either disease-free survival or transplant-related mortality were observed in patients transplanted from unrelated or matched family donors. In multivariate analysis, grade IV acute graft-versus-host disease was an independent factor associated with worse disease-free survival. By contrast, grade I acute graft-versus-host disease and age at diagnosis between 1 and 9 years were favorable prognostic variables. Our study, not intended to evaluate whether transplantation is superior to chemotherapy for children with acute lymphoblastic leukemia in first complete remission and high-risk features, shows that the allograft cured more than 60% of these patients; in the most recent period, the outcome of recipients of grafts from matched family and unrelated donors was comparable.
- Subjects :
- Adolescent
Child
Child, Preschool
Disease-Free Survival
Female
Follow-Up Studies
Graft vs Host Disease diagnosis
Graft vs Host Disease epidemiology
Hematopoietic Stem Cell Transplantation adverse effects
Humans
Infant
Italy epidemiology
Male
Precursor Cell Lymphoblastic Leukemia-Lymphoma diagnosis
Remission Induction
Risk Factors
Transplantation, Homologous adverse effects
Transplantation, Homologous mortality
Treatment Outcome
Hematopoietic Stem Cell Transplantation mortality
Precursor Cell Lymphoblastic Leukemia-Lymphoma mortality
Precursor Cell Lymphoblastic Leukemia-Lymphoma surgery
Registries
Subjects
Details
- Language :
- English
- ISSN :
- 1592-8721
- Volume :
- 98
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Haematologica
- Publication Type :
- Academic Journal
- Accession number :
- 23445874
- Full Text :
- https://doi.org/10.3324/haematol.2012.079707