Outcomes of children, adolescents, and young adults following allogeneic stem cell transplantation for secondary acute myeloid leukemia and myelodysplastic syndromes-The MD Anderson Cancer Center experience.
We conducted a retrospective analysis of outcomes for children and young adults with sAML/sMDS who underwent HSCT at our institution. Thirty-two patients (median age 20 years) with sAML (n=24) and sMDS (n=8) received HSCT between 1990 and 2013. The median time from sAML/sMDS diagnosis to HSCT was 4.1 months (range: 1.2-27.2 months). The transplant regimens were primarily busulfan based (n=19). BM was the primary donor source (n=15). Eleven recipients were transplanted with residual disease. At a median follow-up of 62.3 months (range: 0.4-250.9 months), 14 patients had disease recurrence. Acute GVHD, grade III/IV, occurred in three patients. Causes of death were as follows: disease relapse (n=12), infection (n=2), pneumonia (n=1), pulmonary hemorrhage (n=1), acute GVHD (n=1), and graft failure (n=1). A PS of ≥90% at the time of HSCT had a significant impact on PFS (P=.02). Patients achieving pretransplant primary CR (n=8) and those with sMDS and RA (n=6) had prolonged PFS (P=.04). On multivariate analysis, shorter time to transplantation (≤6 months from diagnosis of sAML/sMDS) was associated with superior OS (P=.0018) and PFS (P=.0005).
Pediatrics, University of Texas MD Anderson Cancer Center, Houston, TX, USA.|Department of Pediatrics, National Cancer Institute, Cairo University, Cairo, Egypt.
Ossama M
OM
Maher
Pediatrics, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Jorge Galvez
JG
Silva
Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Jimin
J
Wu
Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Diane
D
Liu
Pediatric Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Laurence J N
LJ
Cooper
Pediatric Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Nidale
N
Tarek
Pediatric Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Laura
L
Worth
Pediatric Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Dean A
DA
Lee
Pediatric Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Demetrios
D
Petropoulos
Pediatrics, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Anna R K
AR
Franklin
Pediatrics, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Patrick
P
Zweidler-Mckay
Pediatrics, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Robert J
RJ
Wells
Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Gabriela
G
Rondon
Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Richard E
RE
Champlin
Pediatric Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Priti
P
Tewari
D000293:Adolescent; D000328:Adult; D002066:Busulfan / Q000627:therapeutic use; D002648:Child; D005260:Female; D006086:Graft vs Host Disease; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000628:therapy*; D008297:Male; D015999:Multivariate Analysis; D009190:Myelodysplastic Syndromes / Q000628:therapy*; D009364:Neoplasm Recurrence, Local; D012008:Recurrence; D012189:Retrospective Studies; D013997:Time Factors; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult
D002066:Busulfan
allogeneic hematopoietic stem cell transplantation; children and young adults; secondary acute myeloid leukemia and myelodysplastic syndromes