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Marrow transplantation for children with acute leukemia: experience of Pesaro
C Giardini1, P Polchi, G Lucarelli
1Divisione Ematologica, Muraglia Ospedale, Pesaro, Italia.
Insights
Busulphan and cyclophosphamide is a well-tolerated bone marrow transplant preparative regimen for children with leukemia. This regimen shows efficacy comparable to cyclophosphamide and total body irradiation (TBI).
Area of Science:
- Pediatric Oncology
- Hematology
- Transplantation Immunology
Background:
- Acute leukemias are common childhood cancers requiring intensive treatment.
- Bone marrow transplantation (BMT) is a curative option for pediatric leukemia.
- Conditioning regimens are crucial for BMT success, aiming for eradication and immunosuppression.
Purpose of the Study:
- To compare the efficacy and tolerability of two BMT preparative regimens in children with acute leukemia.
- To evaluate busulphan and cyclophosphamide as an alternative to cyclophosphamide and total body irradiation (TBI).
Main Methods:
- Retrospective analysis of 30 children (aged 1-15 years) with acute lymphoblastic leukemia or acute nonlymphoblastic leukemia.
- Patients received BMT from HLA-matched donors.
- Two preparative regimens were used: cyclophosphamide and TBI (n=18) or busulphan and cyclophosphamide (n=12).
Main Results:
- Fifteen patients survived between 7 and 74 months post-transplant.
- The busulphan and cyclophosphamide regimen was well-tolerated.
- Eradicating and immunosuppressive efficacy of busulphan and cyclophosphamide was comparable to TBI-cyclophosphamide.
Conclusions:
- Busulphan and cyclophosphamide is a viable and well-tolerated preparative regimen for pediatric BMT in acute leukemia.
- This regimen offers comparable efficacy to the established TBI-cyclophosphamide regimen.
- Further research may support wider adoption of busulphan-based conditioning in pediatric leukemia BMT.
Abstract:
Thirty children aged 1-15 years with acute lymphoblastic leukemia and acute nonlymphoblastic leukemia were transplanted from HLA-matched donors using two different preparative regimens: 18 patients were prepared with cyclophosphamide and total body irradiation (TBI) while 12 patients received busulphan and cyclophosphamide. Fifteen patients survived 7 to 74 months after transplant. The association of busulphan and cyclophosphamide is a well-tolerated preparation for bone marrow transplant in children with eradicating and immunosuppressive efficacy comparable to that of the well-experienced TBI-cyclophosphamide association.