title: Late effects of allogeneic bone marrow transplantation for children with acute myeloblastic leukemia in first complete remission: the impact of conditioning regimen without total-body irradiation--a report from the Société Française de Greffe de Moelle.
abstract: OBJECTIVE
  To evaluate growth, thyroid function, puberty, cardiac function, and the incidence of cataracts in children who received allogeneic bone marrow transplantation (BMT) for acute myeloblastic leukemia (AML) in first complete remission (CR) after a preparation with or without total-body irradiation (TBI).
  
  
  METHODS
  Among 45 children studied, 26 received busulfan-cyclophosphamide (Bu-Cy) in preparation for transplantation and 19 received TBI. TBI was fractionated in nine cases and delivered as a single dose in 10. Four children in the Bu-Cy group and none in the TBI group had received prior cranial radiation. The mean follow-up duration after BMT was 5.9 years for the whole group.
  
  
  RESULTS
  The mean cumulative changes in height SD score (SDS) were -0.86 at 3 years and -1.56 at 5 years in the TBI group, whereas these changes were only -0.05 and -0.17 in the Bu-Cy group (P < .01 at 3 and 5 years). The 6-year probability of hypothyroidism was 9% +/- 8% in the Bu-Cy group and 43% +/- 15% after TBI (P < .02). Pubertal development after Bu-Cy was assessable in two girls and five boys: both girls had primary ovarian failure, whereas Leydig cell function appeared to be preserved in the five boys. One child who had received anthracycline when he was less than 1 year old developed cardiac dysfunction 4 years after Bu-Cy. The 6-year probability of cataracts was 70% +/- 13% in the TBI group and 0% after Bu-Cy.
  
  
  CONCLUSIONS
  The use of Bu-Cy represents an alternative transplant cytoreductive regimen for children with AML in first CR, which can reduce the risk of posttransplant growth impairment, thyroid dysfunction, Leydig cell damage, and the incidence of cataracts.
authors.affiliation: Hôpital d'Enfants La Timone and the Institut Paoli-Calmettes, Marseille, France. gmichel@ap_hm.fr
authors.forename: G
authors.initials: G
authors.lastname: Michel
authors.forename: G
authors.initials: G
authors.lastname: Socié
authors.forename: F
authors.initials: F
authors.lastname: Gebhard
authors.forename: F
authors.initials: F
authors.lastname: Bernaudin
authors.forename: I
authors.initials: I
authors.lastname: Thuret
authors.forename: J P
authors.initials: JP
authors.lastname: Vannier
authors.forename: F
authors.initials: F
authors.lastname: Demeocq
authors.forename: G
authors.initials: G
authors.lastname: Leverger
authors.forename: J L
authors.initials: JL
authors.lastname: Pico
authors.forename: H
authors.initials: H
authors.lastname: Rubie
authors.forename: F
authors.initials: F
authors.lastname: Mechinaud
authors.forename: J
authors.initials: J
authors.lastname: Reiffers
authors.forename: N
authors.initials: N
authors.lastname: Gratecos
authors.forename: X
authors.initials: X
authors.lastname: Troussard
authors.forename: J P
authors.initials: JP
authors.lastname: Jouet
authors.forename: G
authors.initials: G
authors.lastname: Simonin
authors.forename: E
authors.initials: E
authors.lastname: Gluckman
authors.forename: D
authors.initials: D
authors.lastname: Maraninchi
mesh_terms: D000293:Adolescent; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage / Q000009:adverse effects; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002066:Busulfan / Q000008:administration & dosage / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D018572:Disease-Free Survival; D005260:Female; D006128:Growth / Q000187:drug effects / Q000528:radiation effects; D006801:Humans; D007223:Infant; D015470:Leukemia, Myeloid, Acute / Q000532:radiotherapy / Q000628:therapy*; D008297:Male; D011627:Puberty / Q000187:drug effects*; D019172:Transplantation Conditioning / Q000379:methods*; D014916:Whole-Body Irradiation
chemical_list: D018906:Antineoplastic Agents, Alkylating; D003520:Cyclophosphamide; D002066:Busulfan