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Bone marrow transplantation in pediatric patients with therapy-related myelodysplasia and leukemia.

Leahey AM, Friedman DL, Bunin NJ
Bone Marrow Transplant. 1999 23 (1): 21-5

PMID: 10037046 · DOI:10.1038/sj.bmt.1701517

Eleven children underwent BMT for therapy-related MDS or leukemia, four from HLA-identical siblings and seven from unrelated donors. Ten of the 11 were conditioned with busulfan and cyclophosphamide as the majority had received prior irradiation to the chest and/or abdomen. All patients engrafted. Regimen-related toxicity was more common when compared to historical controls. Eight patients developed acute GVHD and four of eight who survived 100 days post transplant developed extensive chronic GVHD. Non-relapse related mortality occurred in three patients. Five patients developed recurrent malignancy: one died from recurrence of osteosarcoma, three died of recurrent leukemia or MDS and another developed two subsequent malignancies (duodenal carcinoma and anaplastic astrocytoma). Three survive disease-free at 14+, 22+ and 43+ months for a 2 year actuarial cancer-free survival of 24% (95% confidence interval = 5-53%). Although allogeneic BMT can be curative, regimen-related toxicity is frequent and recurrent malignancy remains the major obstacle.

MeSH Terms (15)

Bone Marrow Transplantation Busulfan Child Child, Preschool Cyclophosphamide Female Graft Survival Humans Immunosuppressive Agents Infant Leukemia Male Myelodysplastic Syndromes Transplantation, Homologous Treatment Outcome

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