|
|
 Previous Article | Table of Contents | Next Article 
Blood, 15 March 2002, Vol. 99, No. 6, pp. 2002-2008
CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS
Factors associated with outcome after unrelated marrow
transplantation for treatment of acute lymphoblastic leukemia
in children
Ann E. Woolfrey,
Claudio Anasetti,
Barry Storer,
Kristine Doney,
Laurie A. Milner,
Eric L. Sievers,
Paul Carpenter,
Paul Martin,
Effie Petersdorf,
Frederick R. Appelbaum,
John A. Hansen, and
Jean E. Sanders
From the Fred Hutchinson Cancer Research Center and
University of Washington Departments of Pediatrics and Medicine,
Seattle, WA.
Acute lymphoblastic leukemia (ALL) is the most common indication
for transplantation of marrow from unrelated donors in children. We
analyzed results of this procedure in children with ALL treated according to a standard protocol to determine risk factors for outcome.
From January 1987 to 1999, 88 consecutively seen patients with ALL who
were younger than 18 years received a marrow transplant from an
HLA-matched (n = 56) or partly matched (n = 32) unrelated donor
during first complete remission (CR1; n = 10), second remission (CR2;
n = 34), third remission (CR3; n = 10), or relapse (n = 34).
Patients received cyclophosphamide and fractionated total-body irradiation as conditioning treatment and were given methotrexate and
cyclosporine for graft-versus-host disease (GVHD) prophylaxis. Three-year rates of leukemia-free survival (LFS) according to phase of
disease were 70% for CR1, 46% for CR2, 20% for CR3, and 9% for
relapse (P < .0001). Three-year cumulative relapse rates were 10%, 33%, 20%, and 50%, respectively, and 3-year cumulative rates of death not due to relapse were 20%, 22%, 60%, and 41%, respectively, for patients with CR1, CR2, CR3, and relapse. Grades III
to IV acute GVHD occurred in 43% of patients given HLA-matched transplants and in 59% given partly matched transplants
(P = .10); clinical extensive chronic GVHD occurred in
32% and 38%, respectively (P = .23). LFS rates were
lower in patients with advanced disease (P < .0001), age
10 years or older (P = .002), or short duration of CR1
(P = .007). Thus, in addition to phase of disease, age and duration of CR1 were predictors of outcome after unrelated-donor transplantation for treatment of ALL in children. Outcome was particularly favorable in younger patients with early phases of the disease.
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati What's this?
This article has been cited by other articles:
|
|
|
|
 
M. A. Pulsipher, K. M. Boucher, D. Wall, H. Frangoul, M. Duval, R. K. Goyal, P. J. Shaw, A. E. Haight, M. Grimley, S. A. Grupp, et al.
Reduced-intensity allogeneic transplantation in pediatric patients ineligible for myeloablative therapy: results of the Pediatric Blood and Marrow Transplant Consortium Study ONC0313
Blood,
August 13, 2009;
114(7):
1429 - 1436.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
U. Creutzig, M. Zimmermann, G. Kaspers, and D. Reinhardt
Postremission Management of Acute Myelogenous Leukemia in Children and Adolescents with and without Hematopoietic Stem Cell Transplantation in European and U.S. Study Groups
ASCO Educational Book,
January 1, 2009;
2009(1):
609 - 615.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Balduzzi, P. De Lorenzo, A. Schrauder, V. Conter, C. Uderzo, C. Peters, T. Klingebiel, J. Stary, M. S. Felice, E. Magyarosy, et al.
Eligibility for allogeneic transplantation in very high risk childhood acute lymphoblastic leukemia: the impact of the waiting time
Haematologica,
June 1, 2008;
93(6):
925 - 929.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
U. M. Saarinen-Pihkala, C. Heilmann, J. Winiarski, A. Glomstein, J. Abrahamsson, J. Arvidson, A. N. Bekassy, E. Forestier, G. Jonmundsson, H. Schroeder, et al.
Pathways Through Relapses and Deaths of Children With Acute Lymphoblastic Leukemia: Role of Allogeneic Stem-Cell Transplantation in Nordic Data
J. Clin. Oncol.,
December 20, 2006;
24(36):
5750 - 5762.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Eapen, E. Raetz, M.-J. Zhang, C. Muehlenbein, M. Devidas, T. Abshire, A. Billett, A. Homans, B. Camitta, W. L. Carroll, et al.
Outcomes after HLA-matched sibling transplantation or chemotherapy in children with B-precursor acute lymphoblastic leukemia in a second remission: a collaborative study of the Children's Oncology Group and the Center for International Blood and Marrow Transplant Research
Blood,
June 15, 2006;
107(12):
4961 - 4967.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. E. Sanders, H. J. Im, P. A. Hoffmeister, T. A. Gooley, A. E. Woolfrey, P. A. Carpenter, R. G. Andrews, E. M. Bryant, and F. R. Appelbaum
Allogeneic hematopoietic cell transplantation for infants with acute lymphoblastic leukemia
Blood,
May 1, 2005;
105(9):
3749 - 3756.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. E. Sanders, K. A. Guthrie, P. A. Hoffmeister, A. E. Woolfrey, P. A. Carpenter, and F. R. Appelbaum
Final adult height of patients who received hematopoietic cell transplantation in childhood
Blood,
February 1, 2005;
105(3):
1348 - 1354.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Fasth and J. Wahlstrom
Preimplantation Testing to Produce an HLA-Matched Donor Infant
JAMA,
August 18, 2004;
292(7):
803 - 803.
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. B. Maris, D. Niederwieser, B. M. Sandmaier, B. Storer, M. Stuart, D. Maloney, E. Petersdorf, P. McSweeney, M. Pulsipher, A. Woolfrey, et al.
HLA-matched unrelated donor hematopoietic cell transplantation after nonmyeloablative conditioning for patients with hematologic malignancies
Blood,
September 15, 2003;
102(6):
2021 - 2030.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
