• Medientyp: E-Artikel
  • Titel: Allogeneic bone marrow transplantation for chronic myelomonocytic leukemia in childhood: a report from the European Working Group on Myelodysplastic Syndrome in Childhood
  • Beteiligte: Locatelli, F; Niemeyer, C; Angelucci, E; Bender-Götze, C; Burdach, S; Ebell, W; Friedrich, W; Hasle, H; Hermann, J; Jacobsen, N; Klingebiel, T; Kremens, B; Mann, G; Pession, A; Peters, C; Schmid, H J; Stary, J; Suttorp, M; Uderzo, C; van't Veer-Korthof, E T; Vossen, J; Zecca, M; Zimmermann, M
  • Quelle: ; ( 1997 )
  • Erschienen: American Society of Clinical Oncology (ASCO), 1997
  • Sprache: Englisch
  • ISSN: 0732-183X; 1527-7755
  • Schlagwörter: Cancer Research ; Oncology
  • Beschreibung: <jats:sec><jats:title>PURPOSE</jats:title><jats:p> To evaluate the role of allogeneic bone marrow transplantation (BMT) in children with chronic myelomonocytic leukemia (CMML). </jats:p></jats:sec><jats:sec><jats:title>PATIENTS AND METHODS</jats:title><jats:p> Forty-three children with CMML given BMT and reported to the European Working Group on Myelodysplastic Syndrome in Childhood (EWOG-MDS) data base were evaluated. In 25 cases, the donor was a human leukocyte antigen (HLA)-identical or a one-antigen-disparate relative, in four cases a mismatched family donor, and in 14 a matched unrelated donor (MUD). Conditioning regimens consisted of total-body irradiation (TBI) and chemotherapy in 22 patients, whereas busulfan (Bu) with other cytotoxic drugs was used in the remaining patients. </jats:p></jats:sec><jats:sec><jats:title>RESULTS</jats:title><jats:p> Six of 43 patients (14%), five of whom received transplants from alternative donors, failed to engraft. There was a significant difference in the incidences of chronic graft-versus-host disease (GVHD) between children transplanted from compatible/one-antigen-mismatched relatives and from alternative donors (23% and 87%, respectively; P &lt; .005). Probabilities of transplant-related mortality for children given BMT from HLA-identical/one-antigen-disparate relatives or from MUD/ mismatched relatives were 9% and 46%, respectively. The probability of relapse for the entire group was 58%, whereas the 5-year event-free survival (EFS) rate was 31%. The EFS rate for children given BMT from an HLA-identical sibling or one-antigen-disparate relative was 38%. In this latter group, patients who received Bu had a better EFS compared with those given TBI (62% v 11%, P &lt; .01). </jats:p></jats:sec><jats:sec><jats:title>CONCLUSION</jats:title><jats:p> Children with CMML and an HLA-compatible relative should be transplanted as early as possible. Improvement of donor selection, GVHD prophylaxis, and supportive care are needed to ameliorate results of BMT from alternative donors. </jats:p></jats:sec>