Cookies on this website
We use cookies to ensure that we give you the best experience on our website. If you click 'Continue' we'll assume that you are happy to receive all cookies and you won't see this message again. Click 'Find out more' for information on how to change your cookie settings.

To examine relapse, survival and transplant-related complications in relationship to disease- and pre-treatment-related characteristics, we evaluated 132 children, who consecutively received an allogeneic HLA-identical SCT for acute leukaemia in our centre: ALL in first remission (n=24), ALL in second remission (n=53) and AML in first remission (n=55). The source of the stem cells was bone marrow in all but three cases. Most patients (89%) were pre-treated with cyclophosphamide and an age-related dose of TBI. Initially, GVHD prophylaxis consisted of long-course MTX only (n=24), later short-course MTX and CsA (n=102) was given. All patients were nursed in strictly protective isolation and received total gut decontamination to suppress their potentially pathogenic enteric microflora. The 5-year probability of overall survival was 63, 53 and 74% for ALL1, ALL2 and AML1, respectively (median follow-up: 10.6 years). The overall transplant-related mortality was 6%. The incidence of acute GVHD was 17%; 6% was grades II-IV. A higher total biologically effective TBI dose (BED) resulted in a decreased relapse frequency (P=0.034) and increased overall survival. AML patients with acute GVHD got no relapse (P=0.02); this was not the case in ALL patients. Fractionated TBI regimens with higher BED should be evaluated in prospective studies.

Original publication

DOI

10.1038/sj.bmt.1705729

Type

Journal article

Journal

Bone Marrow Transplant

Publication Date

08/2007

Volume

40

Pages

319 - 327

Keywords

Adolescent, Child, Child, Preschool, Dose-Response Relationship, Radiation, Female, Graft Survival, Graft vs Host Disease, Hematopoietic Stem Cell Transplantation, Histocompatibility Testing, Humans, Infant, Kaplan-Meier Estimate, Leukemia, Myeloid, Acute, Male, Precursor Cell Lymphoblastic Leukemia-Lymphoma, Recurrence, Retrospective Studies, Transplantation Conditioning, Transplantation, Homologous, Whole-Body Irradiation