Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Feb;61(2):269-75.
doi: 10.1002/pbc.24739. Epub 2013 Aug 19.

Comparable survival for pediatric acute myeloid leukemia with poor-risk cytogenetics following chemotherapy, matched related donor, or unrelated donor transplantation

Michael J Kelly  1 , John T Horan, Todd A Alonzo, Mary Eapen, Robert B Gerbing, Wensheng He, Beverly J Lange, Susan K Parsons, William G Woods
Affiliations

Comparable survival for pediatric acute myeloid leukemia with poor-risk cytogenetics following chemotherapy, matched related donor, or unrelated donor transplantation

Michael J Kelly et al. Pediatr Blood Cancer. 2014 Feb.

Abstract

Background: We sought to better define the role of hematopoietic cell transplantation (HCT) in first remission (CR1) for high-risk pediatric acute myeloid leukemia (AML).

Procedures: Outcomes were compared among patients aged less than 21 years with cytogenetically defined poor-risk AML treated with chemotherapy, matched related (MRD), or unrelated donor (URD) transplantation in CR1. Poor-risk cytogenetics was defined as monosomy 7/del7q, monosomy 5/del 5q, abnormalities of 3q, t(6;9)(p23;q34), or complex karyotype. Included are patients treated on Children's Oncology Group trials or reported to the Center for International Blood and Marrow Transplant Research from 1989 to 2006.

Results: Of the 233 patients, 123 received chemotherapy, 55 received MRD HCT, and 55 received URD HCT. The 5-year overall survival from the time of consolidation chemotherapy or transplant conditioning was similar: chemotherapy (43% ± 9%), MRD (46% ± 14%), or URD (50% ± 14%), P = 0.99. Similarly, multivariate analysis demonstrated no significant differences in survival [(reference group = chemotherapy); MRD HR 1.08, P = 0.76; URD HR 1.13, P = 0.67] despite lower relapse risk with URD HCT (HR = 0.43, P = 0.01).

Conclusions: Our findings do not provide support for the preferential use of HCT over chemotherapy alone for children with cytogenetically defined poor-risk AML in CR1.

Keywords: acute myeloid leukemia; chemotherapy; hematopoietic cell transplantation; pediatrics.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest: Nothing to declare.

Figures

Fig. 1
Fig. 1
Overall survival (A), relapse risk (B), and treatment related mortality (C) by treatment group.
See this image and copyright information in PMC

References

    1. Niewerth D, Creutzig U, Bierings MB, et al. A review on allogeneic stem cell transplantation for newly diagnosed pediatric acute myeloid leukemia. Blood. 2010;116:2205–2214. - PubMed
    1. Chen AR, Alonzo TA, Woods WG, et al. Current controversies: Which patients with acute myeloid leukaemia should receive a bone marrow transplantation? An American view. Br J Haematol. 2002;118:378–384. - PubMed
    1. Creutzig U, Reinhardt D. Current controversies: Which patients with acute myeloid leukaemia should receive a bone marrow transplantation? A European view. Br J Haematol. 2002;118:365–377. - PubMed
    1. Oliansky DM, Rizzo JD, Aplan PD, et al. The role of cytotoxic therapy with hematopoietic stem cell transplantation in the therapy of acute myeloid leukemia in children: An evidence-based review. Biol Blood Marrow Transplant. 2007;13:1. - PubMed
    1. Horan JT, Alonzo TA, Lyman GH, et al. Impact of disease risk on efficacy of matched related bone marrow transplantation for pediatric acute myeloid leukemia: The Children’s Oncology Group. J Clin Oncol. 2008;26:5797–5801. - PMC - PubMed

Publication types

MeSH terms