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[Allogenic transplantation of hematopoietic stem cells in the treatment of children with high-risk acute leukemia].
Cas Lek Cesk. 1998 Jun 15; 137(12):363-7.CL

Abstract

BACKGROUND

Most children with acute lymphoblastic leukemia (ALL) and increasing number of children with acute myelogenous leukemia (AML) are currently cured with conventional chemotherapy. Despite of this success there is a subset of patients with high-risk features at diagnosis who are predisposed to a very high risk of relapse. Relapse of AML and early bone marrow relapse of ALL can not be cured by conventional chemotherapy. Allogeneic hematopoietic stem cell transplantation (HSCT) is therapeutic option in these children with very high-risk acute leukemia.

METHODS AND RESULTS

Between XI/1989-XII/1996 33 children with acute leukemia (ALL: 22, AML: 11) underwent an allogeneic HSCT from HLA identical related donors (HLA-identical sibling: 30, twin: 1, other HLA-identical relative: 2) at the 2nd Dept. of Pediatrics, University Hospital Motol. Median age of our group was 9 years (1.5-19 y.), boys (n = 23) clearly dominated over the girls (n = 10). The resource of stem cells was bone marrow in 31 children, bone marrow and peripheral blood progenitor cells (PBPC) and PBPC in one child respectively. Myeloablative conditioning regimen varied, consisting of total body irradiation and chemotherapy in 21 children and chemotherapy in 12 children. HSCT was performed in first complete remission of acute leukemia in 9 children (AML: 7, ALL: 2), in second remission in 14 children (AML: 2, ALL: 12), in third remission in 4 children (ALL: 4). Six children underwent HSCT in first partial remission (n = 1) and in second (n = 4) or third (n = 1) chemoresistant relapse. Seven (21%) children died due to post-transplant complications. Nine (28%) children suffered from clinically significant acute graft-versus-host reaction (GVH) and 15% (4/27) children who survived 100 days post-transplant suffered from chronic GVH disease. Relapse of leukemia was diagnosed in 39% (12/31) children. Fourteen (42%) children are alive and well in continuous remission with median follow-up 42 months.

CONCLUSIONS

Allogeneic HSCT can cure children with very high-risk acute leukemia in the situations where conventional chemotherapy fails. Relapse of leukemia and GVH reaction are most important causes of post-transplant morbidity and mortality.

Authors+Show Affiliations

II. dĕtská klinika 2. LF UK a FN Motol, Praha.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

cze

PubMed ID

9721472

Citation

Starý, J, et al. "[Allogenic Transplantation of Hematopoietic Stem Cells in the Treatment of Children With High-risk Acute Leukemia]." Casopis Lekaru Ceskych, vol. 137, no. 12, 1998, pp. 363-7.
Starý J, Kobylka P, Sedlácek P, et al. [Allogenic transplantation of hematopoietic stem cells in the treatment of children with high-risk acute leukemia]. Cas Lek Cesk. 1998;137(12):363-7.
Starý, J., Kobylka, P., Sedlácek, P., Komrska, V., Vávra, V., Syrůcková, Z., Smísek, P., Hrubá, A., Korínková, P., Matĕjková, E., Cukrová, V., Dolezalová, L., Loudová, M., Sejkorová, J., & Kvĕch, J. (1998). [Allogenic transplantation of hematopoietic stem cells in the treatment of children with high-risk acute leukemia]. Casopis Lekaru Ceskych, 137(12), 363-7.
Starý J, et al. [Allogenic Transplantation of Hematopoietic Stem Cells in the Treatment of Children With High-risk Acute Leukemia]. Cas Lek Cesk. 1998 Jun 15;137(12):363-7. PubMed PMID: 9721472.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Allogenic transplantation of hematopoietic stem cells in the treatment of children with high-risk acute leukemia]. AU - Starý,J, AU - Kobylka,P, AU - Sedlácek,P, AU - Komrska,V, AU - Vávra,V, AU - Syrůcková,Z, AU - Smísek,P, AU - Hrubá,A, AU - Korínková,P, AU - Matĕjková,E, AU - Cukrová,V, AU - Dolezalová,L, AU - Loudová,M, AU - Sejkorová,J, AU - Kvĕch,J, PY - 1998/8/29/pubmed PY - 1998/8/29/medline PY - 1998/8/29/entrez SP - 363 EP - 7 JF - Casopis lekaru ceskych JO - Cas Lek Cesk VL - 137 IS - 12 N2 - BACKGROUND: Most children with acute lymphoblastic leukemia (ALL) and increasing number of children with acute myelogenous leukemia (AML) are currently cured with conventional chemotherapy. Despite of this success there is a subset of patients with high-risk features at diagnosis who are predisposed to a very high risk of relapse. Relapse of AML and early bone marrow relapse of ALL can not be cured by conventional chemotherapy. Allogeneic hematopoietic stem cell transplantation (HSCT) is therapeutic option in these children with very high-risk acute leukemia. METHODS AND RESULTS: Between XI/1989-XII/1996 33 children with acute leukemia (ALL: 22, AML: 11) underwent an allogeneic HSCT from HLA identical related donors (HLA-identical sibling: 30, twin: 1, other HLA-identical relative: 2) at the 2nd Dept. of Pediatrics, University Hospital Motol. Median age of our group was 9 years (1.5-19 y.), boys (n = 23) clearly dominated over the girls (n = 10). The resource of stem cells was bone marrow in 31 children, bone marrow and peripheral blood progenitor cells (PBPC) and PBPC in one child respectively. Myeloablative conditioning regimen varied, consisting of total body irradiation and chemotherapy in 21 children and chemotherapy in 12 children. HSCT was performed in first complete remission of acute leukemia in 9 children (AML: 7, ALL: 2), in second remission in 14 children (AML: 2, ALL: 12), in third remission in 4 children (ALL: 4). Six children underwent HSCT in first partial remission (n = 1) and in second (n = 4) or third (n = 1) chemoresistant relapse. Seven (21%) children died due to post-transplant complications. Nine (28%) children suffered from clinically significant acute graft-versus-host reaction (GVH) and 15% (4/27) children who survived 100 days post-transplant suffered from chronic GVH disease. Relapse of leukemia was diagnosed in 39% (12/31) children. Fourteen (42%) children are alive and well in continuous remission with median follow-up 42 months. CONCLUSIONS: Allogeneic HSCT can cure children with very high-risk acute leukemia in the situations where conventional chemotherapy fails. Relapse of leukemia and GVH reaction are most important causes of post-transplant morbidity and mortality. SN - 0008-7335 UR - https://www.unboundmedicine.com/medline/citation/9721472/[Allogenic_transplantation_of_hematopoietic_stem_cells_in_the_treatment_of_children_with_high_risk_acute_leukemia]_ L2 - http://www.diseaseinfosearch.org/result/7171 DB - PRIME DP - Unbound Medicine ER -