title: Improvement in outcome for children receiving allogeneic bone marrow transplantation in first remission of acute myeloid leukemia: a report from the Groupe d'Etude des Greffes de Moelle Osseuse.
abstract: OBJECTIVE
  We retrospectively analyzed the outcome of children with acute myeloid leukemia (AML) in first complete remission (CR) who received HLA-identical bone marrow transplantation (BMT) in 13 French transplant centers.
  
  
  METHODS
  Seventy-four children were treated from June 1979 through December 1990. The conditioning regimen included total-body irradiation (TBI) in 54 cases and busulfan in 20. Prophylaxis of graft-versus-host disease (GVHD) consisted of cyclosporine (CycloA) plus methotrexate (MTX) for 38 patients, MTX for 17, CycloA for 18, and T depletion without other prophylaxis for one. The mean value of the interval from diagnosis to transplantation was 167 days.
  
  
  RESULTS
  Sixteen patients died of transplant-related complications, 12 relapsed, and 46 are alive in continuous remission with a median follow-up of 46 months. We examined results obtained over three successive periods: 1979 to 1982 (n = 14 children), 1983 to 1986 (n = 29), and 1987 to 1990 (n = 31). Probabilities of event-free survival (EFS) were 43%, 48%, and 82% for the three successive periods, respectively (P < .02). This improvement in EFS was linked to a decreased risk of transplant-related mortality: 36%, 36%, and 3%, respectively (P < .01). Other factors associated with a better EFS in the univariate analysis were a short time interval from diagnosis to transplant (< 120 days), the absence of significant (grade > or = 2) acute GVHD, and the absence of chronic GVHD. In the multivariate analysis, two factors had a favorable impact on long-term survival: the year of transplantation (years 1987 to 1990 v others) and the absence of acute GVHD.
  
  
  CONCLUSIONS
  The outcome for children receiving allogeneic BMT in first CR of AML has improved in France during recent years.
authors.affiliation: Institut Paoli-Calmettes, Marseille, France.
authors.forename: G
authors.initials: G
authors.lastname: Michel
authors.forename: E
authors.initials: E
authors.lastname: Gluckman
authors.forename: D
authors.initials: D
authors.lastname: Blaise
authors.forename: H
authors.initials: H
authors.lastname: Esperou-Bourdeau
authors.forename: J P
authors.initials: JP
authors.lastname: Vernant
authors.forename: M
authors.initials: M
authors.lastname: Kuentz
authors.forename: P
authors.initials: P
authors.lastname: Bordigoni
authors.forename: N
authors.initials: N
authors.lastname: Milpied
authors.forename: H
authors.initials: H
authors.lastname: Rubie
authors.forename: I
authors.initials: I
authors.lastname: Thuret
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000704:Analysis of Variance; D016026:Bone Marrow Transplantation / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D016572:Cyclosporine / Q000627:therapeutic use; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D007223:Infant; D007951:Leukemia, Myeloid / Q000601:surgery*; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D012044:Regression Analysis; D012189:Retrospective Studies; D014184:Transplantation, Homologous; D016896:Treatment Outcome
chemical_list: D016572:Cyclosporine; D008727:Methotrexate