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Stancheva et al. (Abstract)

Cellular Therapy and Transplantation (CTT), Vol. 3, No. 12
doi: 10.3205/ctt-2011-No12-abstract54

© The Authors. This abstract is provided under the following license: Creative Commons Attribution 3.0 Unported

Abstract accepted for "5th Raisa Gorbacheva Memorial Meeting Hematopoietic Stem Cell Transplantation in Children and Adults", Saint Petersburg, Russia, September 18–20, 2011

Preliminary Program

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Results of allogeneic hematopoietic stem cell transplantation in children and adolescents with acute myeloid leukemia

Natalia V. Stancheva, Elena V. Semenova, Maria M. Tretyakova, Svetlana V. Razumova, Tatiana A. Bykova, Sergey N. Shiryaev, Sergey N. Bondarenko, Andrey V. Kozlov, Anastasia S. Borovkova, Ludmila S. Zubarovskaya, Boris V. Afanasyev

R.M. Gorbacheva Memorial Institute of Children Hematology and Transplantation, St. Petersburg State Pavlov Medical University, St. Petersburg, Russia

Correspondence: Natalia V. Stancheva, R.M. Gorbacheva Memorial Institute of Children Hematology and Transplantation, St. Petersburg Pavlov State Medical University, 6/8, Tolstoy str., St. Petersburg, 197022, Russia, E-mail: n.stancheva@spam is badmail.ru

Abstract

The treatment of children and adolescents with acute myeloid leukemia (AML) has improved over the past decades due to the introduction of more intensive chemotherapy and the use of allogeneic hematopoietic stem cell transplantation (allo-HSCT). However, the timing of allo-HSCT and the efficacy of different conditioning regimens are controversial.

The aim: To estimate results of allo-HSCT in patients (pts) wih AML in different stage (1st complete remission (CR1) high risk, CR2, other stages) excluding the M3 FAB variant.

Patients: Between January 2002 and December 2010, allo-HSCT treatments were performed in 53 pts with a median age of 11 y. Nineteen pts were in CR1, 13 pts in CR2, and the others were in disease progression or 3 CR (salvage group). Unrelated allo-HSCT was performed in 35 pts, and related in 18 pts. The sources were bone marrow (BM) in 20 pts, and peripheral blood stem cells (PBSC) in 33 pts. A myeloablative conditioning regimen (MAC) was used in 25 pts, and reduced intensity conditioning (RIC) in 28 pts. aGvHD prophylaxes were CsA+MTX in 38 pts, CsA +MMF in 6 pts, and Tx+ MMF in 9 pts. The conditioning regimen included hATG 60 mg/kg in 2 pts transplanted from related and in all pts from unrelated donors.

Results: Engraftment was at day +17. Two-year overall survival (OS) in the whole group of patients was 45 %. Of these, patients were in CR1: 68%, in CR2: 45%, others: 22%; MAC: 63%, RIC: 30%. MAC demonstrated an advantage versus RIC in CR1 and CR 2: OS was 72% vs 40%; and in the salvage group: OS was 54% vs. 20% (p>0.05), respectively. We did not reveal a significant difference in OS between children and adolescents: 55% vs. 47%; BM and PBSC: 50% vs. 40%; or related or unrelated HSCT: 48% vs 44%, respectively.

Conclusion: Allo-HSCT is effective in children and adolescents with AML, and the best OS was observed in pts with CR1 after MAC. Thus allo-HSCT seems to be treatment of choice in pts with suitable (related or unrelated) donors.

Keywords: acute myeloid leukemia, allogeneic hematopoietic stem cell transplantation, children, adolescents