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Blood, 15 May 2004, Vol. 103, No. 10, pp. 3655-3661. Prepublished online as a Blood First Edition Paper on January 29, 2004; DOI 10.1182/blood-2003-08-2705. This Article Full Text Full Text (PDF) All Versions of this Article: 2003-08-2705v1 103/10/3655    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Neudorf, S. Articles by Woods, W. G. Search for Related Content PubMed PubMed Citation Articles by Neudorf, S. Articles by Woods, W. G. Related Collections Neoplasia Transplantation Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS Allogeneic bone marrow transplantation for children with acute myelocytic leukemia in first remission demonstrates a role for graft versus leukemia in the maintenance of disease-free survival Steven Neudorf, Jean Sanders, Nathan Kobrinsky, Todd A. Alonzo, Allen B. Buxton, Stuart Gold, Dorothy R. Barnard, Joetta D. Wallace, Dagmar Kalousek, Beverly J. Lange, and William G. Woods From the American Family Life Assurance Company (AFLAC) Cancer Center, Emory University/Children's Healthcare, Atlanta, GA; Department of Pediatric Hematology-Oncology, Izaak W. Killam Hospital for Children, Halifax, Nova Scotia, Canada; Department of Preventative Medicine, University of Southern California Keck School of Medicine, Los Angeles; Department of Hematology/Oncology, Roger Maris Cancer Center, Fargo, ND; National Cancer Institute, Bethesda, MD; Fred Hutchinson Cancer Research Center, Seattle, WA; Department of Hematology-Oncology, Children's Hospital of Orange County, Orange, CA; Department of Pediatric Hematology-Oncology, University of North Carolina, Chapel Hill; and Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, PA. In Children's Cancer Group (CCG) study 2891, patients who were recently diagnosed with acute myelocytic leukemia (AML) were assigned randomly to standard- or intensive-timing induction chemotherapy. Patients in first complete remission (CR1) and who had a human leukocyte antigen (HLA)–identical, related donor or a donor disparate at a single class I or II locus were nonrandomly assigned to receive a bone marrow transplant (BMT) by using oral busulfan (16 mg/kg) and cyclophosphamide (200 mg/kg). Methotrexate only was given for graft-versus-host disease (GVHD) prophylaxis. One hundred fifty patients received transplants. Grade 3 or 4 acute GVHD occurred in 9% of patients. Patients younger than 10 years had a lower incidence of grade 3 or 4 GVHD (4.6%) compared with patients 10 years or older (17.4%) (P = .044). Disease-free survival (DFS) at 6 years was 67% and 42% for recipients of intensive- and standard-timing induction therapies, respectively. Multivariate analysis showed that receiving intensive-timing induction therapy (P = .027) and having no hepatomegaly at diagnosis (P = .009) was associated with favorable DFS, and grades 3 and 4 acute GVHD were associated with inferior DFS. Multivariate analysis showed that grades 1 or 2 GVHD (P = .008) and no hepatomegaly at diagnosis (P = .014) were associated with improved relapse-free survival (RFS). Our results show that children older than 10 years are at higher risk for developing severe GVHD; acute GVHD is associated with favorable RFS. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: G. J.L. Kaspers and C. M. Zwaan Pediatric acute myeloid leukemia: towards high-quality cure of all patients Haematologica, November 1, 2007; 92(11): 1519 - 1532. [Abstract] [Full Text] [PDF] I. Yakoub-Agha, F. Mesnil, M. Kuentz, J. M. Boiron, N. Ifrah, N. Milpied, S. Chehata, H. Esperou, J.-P. Vernant, M. Michallet, et al. Allogeneic Marrow Stem-Cell Transplantation From Human Leukocyte Antigen-Identical Siblings Versus Human Leukocyte Antigen-Allelic-Matched Unrelated Donors (10/10) in Patients With Standard-Risk Hematologic Malignancy: A Prospective Study From the French Society of Bone Marrow Transplantation and Cell Therapy J. Clin. Oncol., December 20, 2006; 24(36): 5695 - 5702. [Abstract] [Full Text] [PDF] F. Baron, M. B. Maris, B. M. Sandmaier, B. E. Storer, M. Sorror, R. Diaconescu, A. E. Woolfrey, T. R. Chauncey, M. E.D. Flowers, M. Mielcarek, et al. Graft-Versus-Tumor Effects After Allogeneic Hematopoietic Cell Transplantation With Nonmyeloablative Conditioning J. Clin. Oncol., March 20, 2005; 23(9): 1993 - 2003. [Abstract] [Full Text] [PDF]

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