title: Transplantation for children with acute myeloid leukemia: a comparison of outcomes with reduced intensity and myeloablative regimens.
abstract: The safety and efficacy of reduced-intensity conditioning (RIC) regimens for the treatment of pediatric acute myeloid leukemia is unknown. We compared the outcome of allogeneic hematopoietic cell transplantation in children with acute myeloid leukemia using RIC regimens with those receiving myeloablative-conditioning (MAC) regimens. A total of 180 patients were evaluated (39 with RIC and 141 with MAC regimens). Results of univariate and multivariate analysis showed no significant differences in the rates of acute and chronic graft-versus-host disease, leukemia-free, and overall survival between treatment groups. The 5-year probabilities of overall survival with RIC and MAC regimens were 45% and 48%, respectively (P = .99). Moreover, relapse rates were not higher with RIC compared with MAC regimens (39% vs 39%; P = .95), and recipients of MAC regimens were not at higher risk for transplant-related mortality compared with recipients of RIC regimens (16% vs 16%; P = .73). After carefully controlled analyses, we found that in this relatively modest study population, the data supported a role for RIC regimens for acute myeloid leukemia in children undergoing allogeneic hematopoietic cell transplantation. The data also provided justification for designing a carefully controlled randomized clinical trial that examines the efficacy of regimen intensity in this population.
authors.affiliation: Department of Pediatric Hematology/Oncology, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel;
authors.forename: Menachem
authors.initials: M
authors.lastname: Bitan
authors.forename: Wensheng
authors.initials: W
authors.lastname: He
authors.forename: Mei-Jie
authors.initials: MJ
authors.lastname: Zhang
authors.forename: Hisham
authors.initials: H
authors.lastname: Abdel-Azim
authors.forename: Mouhab Fakhreddine
authors.initials: MF
authors.lastname: Ayas
authors.forename: Bella
authors.initials: B
authors.lastname: Bielorai
authors.forename: Paul A
authors.initials: PA
authors.lastname: Carpenter
authors.forename: Mitchell S
authors.initials: MS
authors.lastname: Cairo
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: Diaz
authors.forename: John T
authors.initials: JT
authors.lastname: Horan
authors.forename: Sonata
authors.initials: S
authors.lastname: Jodele
authors.forename: Carrie L
authors.initials: CL
authors.lastname: Kitko
authors.forename: Kirk R
authors.initials: KR
authors.lastname: Schultz
authors.forename: Morris
authors.initials: M
authors.lastname: Kletzel
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Kasow
authors.forename: Leslie E
authors.initials: LE
authors.lastname: Lehmann
authors.forename: Parinda A
authors.initials: PA
authors.lastname: Mehta
authors.forename: Nirali
authors.initials: N
authors.lastname: Shah
authors.forename: Michael A
authors.initials: MA
authors.lastname: Pulsipher
authors.forename: Tim
authors.initials: T
authors.lastname: Prestidge
authors.forename: Adriana
authors.initials: A
authors.lastname: Seber
authors.forename: Shalini
authors.initials: S
authors.lastname: Shenoy
authors.forename: Ann E
authors.initials: AE
authors.lastname: Woolfrey
authors.forename: Lolie C
authors.initials: LC
authors.lastname: Yu
authors.forename: Stella M
authors.initials: SM
authors.lastname: Davies
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000401:mortality / Q000628:therapy*; D008297:Male; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous; D016896:Treatment Outcome