Results of hemopoietic cell transplantation in the first complete remission in children with acute myeloid leukemia from an intermediate risk group

• Main Authors: Z M Dyshlevaya, E V Skorobogatova, M A Maschan, I P Shipitsyna, Yu V Skvortsova, P E Trakhtman, D N Balashov, Yu V Pashko, E E Kurnikova, E V Suntsova, O V Goronkova, G G Solopova, D D Baidildina, I I Kalinina, L A Khachatryan, M M Shneider, A A Maschan
• Format: Article
• Language: Russian
• Published: "Consilium Medicum" Publishing house 2010-07-01
• Series: Терапевтический архив
• Subjects: acute myeloid leukemia; children; hemopoietic cell transplantations; treatment; efficiency; survival; melphalan
• Online Access: https://ter-arkhiv.ru/0040-3660/article/view/30616
• ISSN: 0040-3660; 2309-5342

Aim. To analyze the results of allogeneic and autologous hemopoietic cell transplantations (allo- and auto-HCT) in children with acute myeloid leukemia (AML) from an intermediate risk group, most of which were performed using lower-intensity conditioning modes. Subjects and methods. The study enrolled 36 children from an intermediate risk group, who had undergone auto-HCT (n = 22) or allo-HCT (n = 14) in December 1994 to December 2008. The patients' age was 0.7 to 16.6 years (median 12.8 years). Chemotherapeutic conditioning regimens were applied to all the patients. Melphalan was a basic myeloablative agent in 83.3% of cases. Results. With a median follow-up of 4.6 years (1.1-13.8 years), three-year relapse-free survival (RFS) was 80.4%; overall survival (OS) was 65.6%. Recurrences were documented only in 6 (16.6%) patients from the auto-HCT. Transplantation-associated mortality (TAM) was 13.8% (five patients died). After allo-HCT versus auto-HCT, RFS, OS, and TAM were 100 and 68.7% (p = 0.03), 93.2 and 55.5% (p = 0.02), and 7.1 and 18.2%, respectively. Acute and chronic graft-versus-host reactions developed in 57.1 and 23.1%, respectively. Conclusion. Transplantation of allogeneic hemopoietic cells from a compatible related donor in the intermediate risk group children with AML, by using melphalan-based conditioning regimen, demonstrates a high survival rate with the minimum toxicity.