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Allo-SCT using BU, CY and melphalan for children with AML in second CR
1Department of Pediatrics, Division of Pediatric Hematology and Oncology, University of Medizinische Hochschule, Hannover, Germany.
Bone Marrow Transplantation
|October 30, 2012
Summary
Hematopoietic stem cell transplant (HSCT) using busulfan, cyclophosphamide, and melphalan conditioning is a viable option for children with acute myeloid leukemia (AML) in second remission, showing a 62% overall survival rate.
Area of Science:
- Hematology
- Pediatric Oncology
- Transplantation Immunology
Background:
- The AML-BFM 98 trial suggested hematopoietic stem cell transplant (HSCT) for acute myeloid leukemia (AML) in second complete remission (CR2).
- This study retrospectively analyzed HSCT outcomes in children with AML in CR2.
Purpose of the Study:
- To evaluate the efficacy and safety of myeloablative conditioning with busulfan, cyclophosphamide, and melphalan (BuCyMel) in pediatric patients undergoing HSCT for AML in CR2.
- To provide data for the ongoing AML SCT-BFM 2007 trial.
Main Methods:
- Retrospective analysis of 109 children with AML in CR2 who underwent HSCT between 1998 and 2009.
- Sixty patients received myeloablative conditioning with BuCyMel, with GVHD prophylaxis using cyclosporine and methotrexate.
Main Results:
- Five-year overall survival (OS) was 62% (±6%).
- Relapse incidence was 35%, and treatment-related mortality was 12% of fatal events.
- A respectable OS was observed despite potential selection bias.
Conclusions:
- HSCT with BuCyMel conditioning in CR2 for pediatric AML is associated with a reasonable OS.
- The findings support the initiation of the prospective AML SCT-BFM 2007 trial for further outcome validation.
