Haploidentical hematopoietic stem cell transplantation in children with acute myeloid leukemia: evolution of method and our data

N.N. Subbotina, I.S. Dolgopolov, A.V. Popa, V.K. Boyarshinov, R.I. Pimenov, and G.L. Mentkevich

Pediatric Oncology and Hematology Research Institute, N.N. Blokhin Russian Cancer Research Center, RAMS, Moscow, Russian Federation


ABSTRACT

This article presents the results of haploidentical stem cell transplantation in children with prognostically unfavorable AML. The study group included 18 pts at the age of 1–18. The disease status at the transplantation time was as follows: high risk AML in first remission (n=4, 22 %), more than two remissions (n=7, 39 %), no remission (n=4, 22 %), or secondary AML in remission (n=3, 17 %). All patients received reduced-intensity conditioning regimen followed by HSCT from haploidentical donors. Hematologic recovery occurred in 17 out of 18 pts in a mean time of 11 days and 12 days for WBC and platelets, respectively. One patient with no remission at the time of transplantation died from leukemia progression and infection with no signs of hematologic recovery. The regimen toxicity was mild and manageable. Acute GVHD of I/II and III degree occurred in 88 % and 6 % of pts, respectively. Chronic GVHD occurred in 85 % of pts, having been quite severe in one pt. The causes of death were infection (n=2, 11 %) or disease relapse/progression (n = 5, 28 %). Eleven pts (61 %) are still alive and disease-free. EFS is 57.5 % with a mean follow-up of 84 (1–144) months. TRM is 13.3 % with a mean follow-up of 124 months.


Keywords: pediatric acute myeloid leukemia, unfavorable prognosis, haploidentical hematopoietic stem cell transplantation.

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