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ORIGINAL ARTICLE
Korean J Pediatr 2012 March;55(3) :100-106.
doi:https://doi.org/10.3345/kjp.2012.55.3.100
Outcome of allogeneic hematopoietic stem cell transplantation for childhood acute lymphoblastic leukemia in second complete remission: a single institution study
Eun-Jung Lee (Lee EJ), Ji Yoon Han (Han JY), Jae Wook Lee (Lee JW), Pil-Sang Jang (Jang PS), Nack-Gyun Chung (Chung NG), Dae-Chul Jeong (Jeong DC), Bin Cho (Cho B), Hack-Ki Kim (Kim HK)
Department of Pediatrics, The Catholic University of Korea, School of Medicine, Seoul, Korea
Corresponding Author: Bin Cho ,Tel: +82-2-2258-6187, Fax: +82-2-588-3589, Email: chobinkr@catholic.ac.kr
Copyright © 2012 by The Korean Pediatric Society
ABSTRACT
Purpose : The survival rate for childhood acute lymphoblastic leukemia (ALL) has improved significantly. However, overall prognosis for the 20 to 25% of patients who relapse is poor, and allogeneic hematopoietic stem cell transplantation (HSCT) offers the best chance for cure. In this study, we identified significant prognostic variables by analyzing the outcomes of allogeneic HSCT in ALL patients in second complete remission (CR). Methods : Fifty-three ALL patients (42 men, 79%) who received HSCT in second CR from August 1991 to February 2009 were included (26 sibling donor HSCTs, 49%; 42 bone marrow transplantations, 79%). Study endpoints included cumulative incidence of acute and chronic graft-versus-host disease (GVHD), relapse, 1-year transplant-related mortality (TRM), disease-free survival (DFS), and overall survival (OS). Results : Cumulative incidences of acute GVHD (grade 2 or above) and chronic GVHD were 45.3% and 28.5%, respectively. The estimated 5-year DFS and OS for the cohort was 45.26.8% and 48.37%, respectively. Only donor type, i.e., sibling versus unrelated, showed significant correlation with DFS in multivariate analysis (P=0.010). The rates of relapse and 1 year TRM were 28.96.4% and 26.46.1%, respectively, and unrelated donor HSCT (P=0.002) and HLA mismatch (P =0.022) were significantly correlated with increased TRM in univariate analysis. Conclusion : In this single institution study spanning more than 17 years, sibling donor HSCT was the only factor predicting a favorable result in multivariate analysis, possibly due to increased TRM resulting from unrelated donor HSCT.
Keywords: Acute lymphoblastic leukemia | Child | Second complete remission | Transplantation
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Immune reconstitution after allogeneic hematopoietic stem cell transplantation in children: a single institution study of 59 patients  2013 January;56(1)
Clinical outcomes of hematopoietic stem cell transplantation from HLA-matched parental donor in childhood acute leukemia  2008 January;51(1)
Second allogeneic hematopoietic stem cell transplantation in children to overcome graft failure or relapse after initial transplant  2006 December;49(12)
Allogeneic Hematopoietic Stem Cell Transplantation in Juvenile Myelomonocytic Leukemia  2005 February;48(2)
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