title: Long-term outcome of allogeneic PBSC transplantation in pediatric patients with hematological malignancies: a report of the Spanish Working Party for Blood and Marrow Transplantation in Children (GETMON) and the Spanish Group for Allogeneic Peripheral Blood Transplantation (GETH).
abstract: We analyzed the clinical outcome in 90 children undergoing allogeneic PBSC transplantation from HLA-identical relative for leukemia. GvHD prophylaxis was CsA+ methotrexate in 50 and CsA+/-steroids in 40. Median CD34+ cells infused were 6 x 10(6)/kg (range, 1.4-32). Median follow-up was 60 months (range, 6-115). CI of transplant-related mortality (TRM) was 18.4+/-4%. On multivariate analysis, high Lansky score (>80) at transplantation was associated with lower TRM (HR, 0.9; P<0.0002). Relapse incidence (RI) was 33.6+/-6%. On multivariate analysis, high Lansky score at transplantation and cGvHD were associated with lower RI (HR, 0.04; P<0.0005 and HR, 0.23; P<0.03, respectively). Disease-free survival (DFS) was 57.8+/-5%. Disease status at transplantation (HR, 0.33; P<0.02), steroid treatment at day +90 (HR, 5.61; P<0.005) and cGvHD (HR, 0.23; P<0.005) had a significant impact on DFS in multivariate analysis. CI of cGvHD was 63.7+/-7%. Patients with cGvHD had better DFS (65+/-5%) because of lower RI (15.7+/-6%) and similar TRM (27.4+/-4%). These data suggest acceptable long-term outcomes after allogeneic PBSC transplantation in children despite the high incidence of cGvHD. These patients had a lower risk of relapse and a better DFS.
authors.affiliation: Department of Pediatrics, Division of Pediatric Hematology Oncology, Hospital Infantil Niño Jesus, Madrid, Spain. mdiaz.hnjs@salud.madrid.org
authors.forename: M A
authors.initials: MA
authors.lastname: Diaz
authors.forename: M
authors.initials: M
authors.lastname: Gonzalez-Vicent
authors.forename: M E
authors.initials: ME
authors.lastname: Gonzalez
authors.forename: A
authors.initials: A
authors.lastname: Verdeguer
authors.forename: A
authors.initials: A
authors.lastname: Martinez
authors.forename: M
authors.initials: M
authors.lastname: Perez-Hurtado
authors.forename: I
authors.initials: I
authors.lastname: Badell
authors.forename: J
authors.initials: J
authors.lastname: de la Rubia
authors.forename: J
authors.initials: J
authors.lastname: Bargay
authors.forename: F
authors.initials: F
authors.lastname: de Arriba
authors.forename: J L
authors.initials: JL
authors.lastname: Diez
authors.forename: D
authors.initials: D
authors.lastname: Caballero
authors.forename: L
authors.initials: L
authors.lastname: Madero
authors.forename: S
authors.initials: S
authors.lastname: Brunet
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000209:etiology / Q000401:mortality* / Q000517:prevention & control; D006405:Hematology; D006801:Humans; D015994:Incidence; D007223:Infant; D007938:Leukemia / Q000150:complications / Q000401:mortality* / Q000628:therapy; D008297:Male; D015999:Multivariate Analysis; D010372:Pediatrics; D036102:Peripheral Blood Stem Cell Transplantation / Q000379:methods / Q000401:mortality; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013030:Spain; D014184:Transplantation, Homologous