Journal of Clinical Pediatrics ›› 2019, Vol. 37 ›› Issue (5): 321-.doi: 10.3969/j.issn.1000-3606.2019.05.001

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Allogenetic hematopoietic stem cell transplantation for children with acute myeloid leukemia

 XIAO Yuhua, LI Chunfu, HE Yuelin, WU Xuedong, PENG Zhiyong, REN Yuqiong, FENG Xiaoqin   

  1. Department of Pediatrics, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong, China
  • Online:2019-05-15 Published:2019-05-15

Abstract:  Objective To analyze clinical efficacy of allo-genetic stem cell transplantation (allo-HSCT) for children with acute myeloid leukemia (AML) and related factors. Methods Forty-nine children with intermediate risk group, high risk group, relapsed AML group who underwent allo-HSCT in Nanfang Hospital from January of 2002 to November of 2017 were retrospectively analyzed in risk classification, HLA type, status before transplantation, transplantation type, source of stem cell and acute or chronic graft versus host disease (GVHD), respectively. Results A total of 49 patients were analyzed, with a median age of 9 years, including 35 boys and 14 girls. The 3 years overall survival (OS) and leukemia free survival (LFS) was 59.2%±7.3% and 50.9%±7.4%, respectively. The 3-year LFS in first remission subgroup, non-related donor subgroup, peripheral blood stem cell transplantation subgroup and intermediate risk group is 69.8%, 69.2%, 73.7% and 65.8%, respectively. Causes of death consists of relapse (13/49,26.5%), severe infection (5/49,10.2%), and multiple organ failure(1/49, 2.0%). Cox regression analysis showed that acute GVHD (RR=3.16, 95%CI: 1.233~8.091, P=0.017) and status before transplantation (partial remission and non remission) (RR=4.76, 95%CI: 1.515~14.939, P=0.008; RR=5.28, 95%CI: 1.683~16.580, P=0.004) can significantly affect the OS and LFS. Conclusion Status before transplantation and acute GVHD can affect the efficacy of allo-HSCT significantly. The most common causes of death are relapse and infection.

Key words: allo-genetic hematopoietic stem cell transplantation; acute myeloid leukemia; child