Outcome of allogeneic bone marrow transplantation for children with advanced acute myeloid leukemia

Eneida Nemecek, T. A. Gooley, A. E. Woolfrey, P. A. Carpenter, D. C. Matthews, J. E. Sanders

Research output: Contribution to journalArticle

48 Citations (Scopus)

Abstract

Allogeneic bone marrow transplantation (BMT) may offer the only chance of cure for children with acute myeloid leukemia (AML) in second complete remission (CR2) or with relapsed disease, but the outcome of these patients has not been clearly defined. We conducted a retrospective study of 58 children, median age 7.4 years (range 0.8-17.3), who received matched related or unrelated BMT at our institution for AML in CR2 (n=12), in untreated first relapse (n=11) or with refractory disease (n=35), to identify risk factors associated with disease-free survival (DFS). Life threatening to fatal regimen-related toxicity was observed in 22% of patients. Estimates of DFS at 5 years (95% confidence interval) for patients in CR2, with untreated first relapse and refractory disease were 58% (27-80%), 36% (11-63%) and 9% (2-21%), respectively. Non-relapse mortality estimates were 0%, 27% (0-54%) and 17% (5-30%), and relapse estimates were 42% (14-70%), 36% (8-65%) and 74% (60-89%), respectively. Advanced disease phase and cytogenetic abnormalities at the time of transplantation were each associated with decreased DFS and increased relapse in multivariable regression models. Survival for children transplanted in CR2 or untreated first relapse is higher than that previously reported, but relapse remains the major cause of treatment failure regardless of disease stage.

Original languageEnglish (US)
Pages (from-to)799-806
Number of pages8
JournalBone Marrow Transplantation
Volume34
Issue number9
DOIs
StatePublished - Nov 2004
Externally publishedYes

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Homologous Transplantation
Bone Marrow Transplantation
Acute Myeloid Leukemia
Recurrence
Disease-Free Survival
Treatment Failure
Chromosome Aberrations
Retrospective Studies
Transplantation
Confidence Intervals
Survival
Mortality

Keywords

  • Acute myeloid leukemia
  • Childhood leukemia

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Outcome of allogeneic bone marrow transplantation for children with advanced acute myeloid leukemia. / Nemecek, Eneida; Gooley, T. A.; Woolfrey, A. E.; Carpenter, P. A.; Matthews, D. C.; Sanders, J. E.

In: Bone Marrow Transplantation, Vol. 34, No. 9, 11.2004, p. 799-806.

Research output: Contribution to journalArticle

Nemecek, Eneida ; Gooley, T. A. ; Woolfrey, A. E. ; Carpenter, P. A. ; Matthews, D. C. ; Sanders, J. E. / Outcome of allogeneic bone marrow transplantation for children with advanced acute myeloid leukemia. In: Bone Marrow Transplantation. 2004 ; Vol. 34, No. 9. pp. 799-806.
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