Document Detail


Allogeneic bone marrow transplantation in children with chronic myelogenous leukemia.
MedLine Citation:
PMID:  11990309     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To determine the outcome of children undergoing allogeneic bone marrow transplantation for chronic myelogenous leukemia (CML) at the authors' institution.
PATIENTS AND METHODS: Between 1985 and 1999, 18 allogeneic bone marrow transplantations were performed in 17 patients with CML at the Hospital for Sick Children in Toronto. Median age at diagnosis was 9.5 years (range 3-17). Fourteen patients had disease in the first chronic phase, one had disease in the second chronic phase, and two had disease in the accelerated phase. Preparative regimens varied, with radiation-based protocols used in eight patients. Thirteen donors were related (11 matched, 2 mismatched); four were unrelated (2 matched, 2 mismatched). Patients received T-cell-replete bone marrow a median of 7.5 months (range 2.2-22) from diagnosis. A median of 3.0 x 10(8)/kg nucleated cells was infused (range 1.6-6.7). Graft-versus-host disease (GVHD) prophylaxis consisted of cyclosporine and methotrexate in 13 children. cyclosporine in three, and methotrexate in one.
RESULTS: Primary graft failure occurred in one patient. Grade 2 acute GVHD or more developed in 11 of the 17 children (64%; grade 2 in 4, grade 3 in 7). Chronic GVHD occurred in 6 of the 16 patients at risk (37.5%; 5 extensive, 1 localized). No patient experienced overt or cytogenetic relapse. There were two deaths (12%): one from acute GVHD and cytomegalovirus pneumonia and the other from chronic GVHD. Probability of 5-year event-free survival was 87 +/- 9%.
CONCLUSIONS: These results strongly support the practice of allotransplantation in children with CML, even in the setting of advanced disease and histoincompatibility. Efforts should be aimed at reducing the transplantation-related death rate.
Authors:
Anjali Sharathkumar; Ian Thornley; E Fred Saunders; Stan Calderwood; Melvin H Freedman; John Doyle
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of pediatric hematology/oncology     Volume:  24     ISSN:  1077-4114     ISO Abbreviation:  J. Pediatr. Hematol. Oncol.     Publication Date:    2002 Mar-Apr
Date Detail:
Created Date:  2002-05-06     Completed Date:  2002-05-23     Revised Date:  2011-10-06    
Medline Journal Info:
Nlm Unique ID:  9505928     Medline TA:  J Pediatr Hematol Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  215-9     Citation Subset:  IM    
Affiliation:
The Hospital for Sick Children, University of Toronto, Ontario, Canada.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Antifungal Agents / therapeutic use
Antimetabolites, Antineoplastic / therapeutic use
Bone Marrow Transplantation*
Child
Child, Preschool
Cyclosporine / therapeutic use
Female
Graft vs Host Disease / prevention & control
Humans
Leukemia, Myelogenous, Chronic, BCR-ABL Positive / mortality,  therapy*
Male
Methotrexate / therapeutic use
Neoplasm Recurrence, Local / mortality,  therapy
Survival Rate
Transplantation, Homologous
Chemical
Reg. No./Substance:
0/Antifungal Agents; 0/Antimetabolites, Antineoplastic; 59-05-2/Methotrexate; 59865-13-3/Cyclosporine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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