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Review
. 2011 Jan;17(1 Suppl):S137-48.
doi: 10.1016/j.bbmt.2010.10.005.

High-risk pediatric acute lymphoblastic leukemia: to transplant or not to transplant?

Michael A Pulsipher  1 , Christina Peters, Ching-Hon Pui
Affiliations
Review

High-risk pediatric acute lymphoblastic leukemia: to transplant or not to transplant?

Michael A Pulsipher et al. Biol Blood Marrow Transplant. 2011 Jan.

Abstract

Because survival with both chemotherapy and allogeneic hematopoietic stem cell transplantation (HSCT) approaches to high-risk pediatric acute lymphoblastic leukemia (ALL) generally improves through the years, regular comparisons of outcomes with either approach for a given indication are needed to decide when HSCT is indicated. Improvements in risk classification are allowing clinicians to identify patients at high risk for relapse early in their course of therapy. Whether patients defined as high risk by new methods will benefit from HSCT requires careful testing. Standardization and improvement of transplant approaches has led to equivalent survival outcomes with matched sibling and well-matched unrelated donors; however, survival using mismatched and haploidentical donors is generally worse. Trials comparing chemotherapy and HSCT must obtain sufficient data about therapy and stratify the analysis to assess the outcomes of best-chemotherapy with best-HSCT approaches.

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Figures

Figure 1
Figure 1
Probability of Event Free Survival according to Transplant Indication and Donor Type
Figure 2
Figure 2
Probability of Survival according to Transplant Indication and Donor Type
Figure 3
Figure 3
Consideration of the Use of HSCT for Newly Defined High Risk Patients
See this image and copyright information in PMC

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