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Author Notes:

Michael Kelly, The Floating Hospital for Children at Tufts Medical Center, 800 Washington St, Box 14, Boston, MA 02111. mkelly3@tuftsmedicalcenter.org.

The authors acknowledge and thank Janet Cowan, PhD, Tufts Medical Center, who assisted with the analysis of cytogenetic data; and Rebecca Burns, research assistant in the Institute for Clinical Research and Health Policy Studies at Tufts Medical Center, who assisted with the preparation of the manuscript.

Authors had no conflicts of interest to declare.

Subjects:

Research Funding:

Grant sponsor: National Cancer Institute; Grant number: KM1 CA 156726.

Grant sponsor: Public Health Service; Grant number: U24-CA76518.

Grant Sponsors: National Heart Lung and Blood Institute; National Institute of Allergy and Infectious Diseases; National Institutes of Health

This work was funded in part by a KM1 award received by Dr. Kelly from the National Cancer Institute (KM1 CA 156726, PI: H. Selker); and Public Health Service grant (U24-CA76518, PI: M.M. Horowitz) from the National Cancer Institute, the National Heart Lung and Blood Institute and the National Institute of Allergy and Infectious Diseases.

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Oncology
  • Hematology
  • Pediatrics
  • acute myeloid leukemia
  • chemotherapy
  • hematopoietic cell transplantation
  • pediatrics
  • STEM-CELL TRANSPLANTATION
  • BONE-MARROW-TRANSPLANTATION
  • CURRENT CONTROVERSIES
  • ONCOLOGY-GROUP
  • CHILDREN
  • THERAPY
  • AML
  • TRIAL
  • ADOLESCENTS
  • MANAGEMENT

Comparable Survival for Pediatric Acute Myeloid Leukemia With Poor-Risk Cytogenetics Following Chemotherapy, Matched Related Donor, or Unrelated Donor Transplantation

Tools:

Journal Title:

Pediatric Blood and Cancer

Volume:

Volume 61, Number 2

Publisher:

, Pages 269-275

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Background: We sought to better define the role of hematopoietic cell transplantation (HCT) in first remission (CR1) for high-risk pediatric acute myeloid leukemia (AML). Procedures: Outcomes were compared among patients aged less than 21 years with cytogenetically defined poor-risk AML treated with chemotherapy, matched related (MRD), or unrelated donor (URD) transplantation in CR1. Poor-risk cytogenetics was defined as monosomy 7/del7q, monosomy 5/del 5q, abnormalities of 3q, t(6;9)(p23;q34), or complex karyotype. Included are patients treated on Children's Oncology Group trials or reported to the Center for International Blood and Marrow Transplant Research from 1989 to 2006. Results: Of the 233 patients, 123 received chemotherapy, 55 received MRD HCT, and 55 received URD HCT. The 5-year overall survival from the time of consolidation chemotherapy or transplant conditioning was similar: chemotherapy (43%±9%), MRD (46%±14%), or URD (50%±14%), P=0.99. Similarly, multivariate analysis demonstrated no significant differences in survival [(reference group=chemotherapy); MRD HR 1.08, P=0.76; URD HR 1.13, P=0.67] despite lower relapse risk with URD HCT (HR=0.43, P=0.01). Conclusions: Our findings do not provide support for the preferential use of HCT over chemotherapy alone for children with cytogenetically defined poor-risk AML in CR1.

Copyright information:

© 2013 Wiley Periodicals, Inc.

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