High transplant-related mortality associated with haematopoietic stem cell transplantation for paediatric therapy-related acute myeloid leukaemia (t-AML). A study on behalf of the United Kingdom Paediatric Blood and Bone Marrow Transplant Group

Bone Marrow Transplant. 2018 Sep;53(9):1165-1169. doi: 10.1038/s41409-018-0157-x. Epub 2018 Mar 15.

Abstract

Paediatric therapy-related acute myeloid leukaemia (t-AML) is rare and the outcome is poor. While allogeneic haematopoietic stem cell transplantation (HSCT) is generally the accepted modality of treatment, data regarding salvage chemotherapy, remission induction, conditioning regimens, transplant-related mortality and outcome is scarce. Between 2000 and2016, 36 children with t-AML were treated in seven UK paediatric HSCT centres. The most common salvage protocol for remission induction was FLAG with or without idarubicin and 28 patients were in complete morphological remission prior to BMT. Only 12 patients survived (33%). Transplant-related mortality (TRM) was the leading cause of death.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Bone Marrow Transplantation
  • Child
  • Child, Preschool
  • Cytarabine / therapeutic use
  • Female
  • Granulocyte Colony-Stimulating Factor / therapeutic use
  • Hematopoietic Stem Cell Transplantation / methods*
  • Hematopoietic Stem Cell Transplantation / mortality
  • Humans
  • Idarubicin / therapeutic use
  • Leukemia, Myeloid, Acute / therapy*
  • Male
  • Neoplasms, Second Primary / therapy*
  • Remission Induction / methods
  • Salvage Therapy / methods
  • Survival Analysis
  • United Kingdom
  • Vidarabine / analogs & derivatives
  • Vidarabine / therapeutic use

Substances

  • Cytarabine
  • Granulocyte Colony-Stimulating Factor
  • Vidarabine
  • Idarubicin

Supplementary concepts

  • FLAG protocol