Unrelated donor bone marrow transplantation in children and young adults with acute myeloid leukaemia in remission.
The role of unrelated donor bone marrow transplantation (UD-BMT) in the management of patients with acute myeloid leukaemia (AML) is uncertain. We describe 18 patients with a median age of 13 years (range 4-31) who received an ex vivo T-cell-depleted UD-BMT for AML (13 in second complete remission (CR2) and five in first complete remission (CR1) with high-risk features). Nine donor recipient pairs were fully matched; eight of these donor-recipient pairs had a single class I HLA mismatch; one patient had both single class I and class II HLA mismatches. Grade II GVHD of the skin occurred in four patients (22%) and limited chronic GVHD in two patients (11%). There have been four deaths: one from relapse and three from infection. With a median follow-up of 27 months, 14 patients survive and the actuarial event-free survival at 2 years is 70 +/- 20% (95% confidence interval). We conclude that unrelated donor BMT can result in prolonged disease-free survival in children and young adults with AML.
Chown
S R
SR
Bone Marrow Transplant Unit (Oncology Day Beds), Bristol Royal Hospital for Sick Children, Bristol.
Marks
D I
DI
Cornish
J M
JM
Pamphilon
D H
DH
Potter
M N
MN
Steward
C G
CG
Oakhill
A
A
D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology; D006801:Humans; D008212:Lymphocyte Depletion; D008297:Male; D009894:Opportunistic Infections / Q000150:complications; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications / Q000628:therapy*; D012008:Recurrence; D016019:Survival Analysis; D015996:Survival Rate; D013601:T-Lymphocytes; D014184:Transplantation, Homologous; D014777:Virus Diseases / Q000150:complications