Mobilization of PML-RARA negative blood stem cells and salvage with autologous peripheral blood stem cell transplantation in children with relapsed acute promyelocytic leukemia.
BACKGROUND
Relapsed acute promyleocytic leukemia (APL) is treated with re-induction chemotherapy, commonly arsenic trioxide, and stem cell transplantation (SCT). The effect of arsenic trioxide on autologous peripheral blood stem cell collection is unknown.


METHODS
Five pediatric patients with relapsed APL had PML-RARA negative peripheral blood stem cells mobilized (four after arsenic trioxide) and underwent autologous SCT after cyclophosphamide (60 mg/kg x 2) and total body irradiation (TBI-fractionated 1,200 cGy) conditioning.


RESULTS
All five patients remain in molecular remission a median of 20 months post-transplant.


CONCLUSIONS
Autologous SCT performed during molecular remission is a treatment option for pediatric patients with relapsed APL and may provide durable leukemia-free survival without the complications of allogeneic transplantation.
Termuhlen
Amanda M
AM
Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, USA. amanda.termuhlen@nationwidechildrens.org
Klopfenstein
Kathryn
K
Olshefski
Randall
R
Rosselet
Robin
R
Yeager
Nicholas D
ND
Soni
Sandeep
S
Gross
Thomas G
TG
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006085:Graft Survival; D006412:Hematopoietic Stem Cells / Q000378:metabolism*; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000378:metabolism / Q000601:surgery*; D015514:Oncogene Proteins, Fusion / Q000378:metabolism; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects; D012008:Recurrence; D016879:Salvage Therapy; D014182:Transplantation, Autologous / Q000009:adverse effects
D015514:Oncogene Proteins, Fusion; C093476:promyelocytic leukemia-retinoic acid receptor alpha fusion oncoprotein