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Pediatric Transplants

A comparison of the outcomes of children with acute myelogenous leukemia in either first or second complete remission (CR1 vs CR2) following allogeneic hematopoietic stem cell transplantation at a single transplant center

Bone Marrow Transplantation volume 41, pages 941–945 (2008)Cite this article

Abstract

We reviewed 70 consecutive children with AML who received hematopoietic stem cell transplantation (HSCT) in our institution between 1994 and 2005. Forty-seven children were transplanted in CR1 and 23 were transplanted in CR2. BU/CY was the most common pretransplant conditioning regimen for CR1 patients and a TBI-based conditioning regimen was the most common regimen for CR2 patients. Most patients transplanted in CR1 (81%) received related donor HSCT, whereas most of the CR2 patients (74%) received unrelated donor HSCT. Expectedly, there was a significant increase in acute GVHD incidence in CR2 patients (40 vs 25% for grades I–II and 30 vs 10% for grades III–IV; P=0.02) and a significant increase in transplant-related mortality (38 vs 11%; P=0.01). Although the difference between 3-year EFS for CR1 and CR2 was not statistically significant, there was a significantly superior 3-year overall survival for CR1 patients (74 vs 51%; P=0.05). Children with relapsed AML who achieve and maintain remission until HSCT, have a reasonable survival, but the outcome of children receiving HSCT in CR1 remains superior.

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Acknowledgements

We are indebted to the patients, families, nursing and medical staff of the 8B unit and the oncology units at our partner centers for the provision of excellent patient care, which has been crucial for the achievement of the results reported here.

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  1. Division of Haematology/Oncology, Hospital for Sick Children, University of Toronto, Ontario, Canada

    A Gassas, M Kashif Ishaqi, S Afzal, T Finkelstein-Shechter & J Doyle

  2. Division of Clinical Research Support Unit, Hospital for Sick Children, University of Toronto, Ontario, Canada

    A Dupuis

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  1. A Gassas
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  2. M Kashif Ishaqi
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Correspondence to A Gassas.

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Gassas, A., Ishaqi, M., Afzal, S. et al. A comparison of the outcomes of children with acute myelogenous leukemia in either first or second complete remission (CR1 vs CR2) following allogeneic hematopoietic stem cell transplantation at a single transplant center. Bone Marrow Transplant 41, 941–945 (2008). https://doi.org/10.1038/bmt.2008.16

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