Related Experiment Videos
ABMT for children AML: Italian experience. GITMO-AIEOP Groups
Insights
Autologous bone marrow transplantation (ABMT) shows promising results for children with acute myeloid leukemia (AML) in second remission, offering better outcomes than standard chemotherapy. Further research is needed for first remission cases.
Area of Science:
- Pediatric Hematology Oncology
- Hematopoietic Stem Cell Transplantation
- Acute Myeloid Leukemia Research
Background:
- Acute Myeloid Leukemia (AML) in children presents significant treatment challenges.
- Autologous Bone Marrow Transplantation (ABMT) is a potential therapeutic option for pediatric AML.
- Evaluating different conditioning regimens is crucial for optimizing ABMT outcomes.
Purpose of the Study:
- To analyze the efficacy of ABMT in pediatric AML patients in first and second remission.
- To compare outcomes based on various conditioning regimens used in ABMT.
- To assess the role of ABMT in high-risk pediatric AML patients.
Main Methods:
- Retrospective analysis of 93 Italian children under 14 with AML in first or second complete remission (CR).
- Patients underwent ABMT with conditioning regimens including BAVC, TBI + CHT, or HD CHT.
- Data collected on relapse rates and disease-free survival (DFS) at specified time points.
Main Results:
- In first CR, overall DFS was 39% at 66 months, with TBI + CHT showing better DFS (61% at 48 months) than BAVC (35% at 66 months).
- In second CR, overall DFS was 59% at 65 months, with TBI + CHT demonstrating superior DFS (65% at 65 months) compared to BAVC (56% at 50 months).
- ABMT in second CR yielded significantly better results than standard chemotherapy alone.
Conclusions:
- ABMT in second CR for pediatric AML patients demonstrates superior outcomes compared to conventional chemotherapy.
- While results in first CR require further investigation due to study heterogeneity, ABMT is a valuable option for high-risk pediatric AML.
- This study highlights the potential of ABMT in improving survival rates for specific pediatric AML populations.
Abstract:
We report data from an Italian survey on ABMT in 93 AML children less than 14 years in 1st or 2nd remission performed in 15 Centers. Different conditioning regimens have been employed: BAVC, an original schedule of chemotherapy; TBI plus Cy and/or other drugs (TBI + CHT); other high dose chemotherapy schedules (HD CHT). 62 patients have been transplanted in 1st CR; 38 have been conditioned with BAVC, 16 with TBI + CHT and 8 with HD CHT. Relapses were 21 in the BAVC group (DFS = 35% at 66 months), 5 in the TBI group (DFS = 61% at 48 months) and 5 in the HD CHT group; overall DFS is 39% at 66 months. 31 patients have been transplanted in 2nd CR; 14 were conditioned with BAVC and 16 with TBI + CHT; 6 patients relapsed in the first group, DFS is 56% at 50 months; in the second group 2 early deaths and 3 relapses occurred, DFS is 65% at 65 months. 1 patient in 2nd CR, conditioned with HD CHT, died during aplasia. Overall DFS is 59% at 65 months. Although no final conclusions concerning ABMT in AML children may be drawn from this retrospective study because of heterogeneity of population and methods, results obtained in 2nd CR are clearly better to those obtained with standard chemotherapy alone, confirming the role of ABMT in this high risk category of patients.