title: Non-TBI hematopoietic stem cell transplantation in pediatric AML patients: a single-center experience.
abstract: BACKGROUND
  Hematopoietic stem cell transplantation (HSCT) has been established as a promising treatment in acute myeloid leukaemia (AML). Several studies have been performed to minimize the toxicity of HSCT in children without impairing the efficacy. We report our long-term results of HSCT in pediatric AML patients using non-total body irradiation conditioning regimen.
  
  
  METHODS
  From May 1991 to June 2010, 133 pediatric patients with AML (age<15 y) who were referred to our institute underwent autologous (auto-) or allogeneic (allo-) HSCT. The conditioning regimen consisted of oral busulfan plus etoposide in auto-HSCT patients and oral busulfan plus cyclophosphamide in allo-HSCT patients.
  
  
  RESULTS
  Overall survival (OS), leukemia-free survival (LFS), probability of relapse, and transplantation-related mortality at 3 years were 67.6%, 62.2.5%, 27.3%, and 10.1%, respectively. There was no significant difference between allo-HSCT and auto-HSCT groups. In multivariable analysis using Cox proportional hazards regression model, male sex was associated with significantly improved OS (P<0.001) and LFS (P=0.022). An age ≤3 years was associated with higher relapse (P=0.034) and worse OS (P=0.001) and LFS (P=0.014).
  
  
  CONCLUSIONS
  The role of allo-HSCT in pediatric AML patients in first complete remission is uncertain. Further randomized studies are recommended to clarify the optimal postremission therapy in these patients.
authors.affiliation: Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran. ahamdi@gmail.com
authors.forename: Amir A
authors.initials: AA
authors.lastname: Hamidieh
authors.forename: Kamran
authors.initials: K
authors.lastname: Alimoghaddam
authors.forename: Mohammad
authors.initials: M
authors.lastname: Jahani
authors.forename: Babak
authors.initials: B
authors.lastname: Bahar
authors.forename: Seyed Asadollah
authors.initials: SA
authors.lastname: Mousavi
authors.forename: Masood
authors.initials: M
authors.lastname: Iravani
authors.forename: Maryam
authors.initials: M
authors.lastname: Behfar
authors.forename: Arash
authors.initials: A
authors.lastname: Jalali
authors.forename: Mahdi
authors.initials: M
authors.lastname: Jalili
authors.forename: Amir
authors.initials: A
authors.lastname: Hamdi
authors.forename: Ardeshir
authors.initials: A
authors.lastname: Ghavamzadeh
mesh_terms: D000293:Adolescent; D002066:Busulfan / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003520:Cyclophosphamide / Q000627:therapeutic use; D018572:Disease-Free Survival; D005047:Etoposide / Q000627:therapeutic use; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D007223:Infant; D053208:Kaplan-Meier Estimate; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D019653:Myeloablative Agonists / Q000627:therapeutic use; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D019172:Transplantation Conditioning / Q000379:methods*; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous
chemical_list: D019653:Myeloablative Agonists; D005047:Etoposide; D003520:Cyclophosphamide; D002066:Busulfan