Matched-unrelated-donor bone marrow transplantation for children with leukemia
Journal
Journal of the Formosan Medical Association
Journal Volume
104
Journal Issue
6
Pages
448-451
Date Issued
2005
Abstract
Background and Purpose: This report describes the results of matched-unrelated-donor transplant for leukemia or myelodysplasia in the first 23 recipient children at a single medical center in Taiwan. Methods: Between August 1994 and February 2003, 23 consecutive children with leukemia or myelodysplasia underwent matched-unrelated-donor bone marrow transplantation (BMT). The preparative regimen consisted of fractionated total body irradiation and cyclophosphamide in 6 patients; busulfan in combination with etoposide and cyclophosphamide in 4 patients who received cranial irradiation before transplantation; and busulfan and cyclophosphamide in 13 patients. Results: Engraftment was achieved in 91.3% of cases. Acute graft-versus-host disease (GVHD) occurred in 18 of 21 patients who engrafted (85.7%). Event-free survival for all patients was 24.46 ± 9.24%. The 12 children with standard-risk disease had better event-free survival than the 11 children with high-risk disease (46.88 ± 15.03% vs 0%, p ? 0.001). Conclusions: The major obstacles to successful matched-unrelated-donor BMT are acute GVHD, relapse and infection. Early transplantation and patient selection, prophylactic and therapeutic maneuvers for GVHD, as well as appropriate donor selection and virus prophylaxis may improve the results.
SDGs
Other Subjects
aciclovir; antibiotic agent; busulfan; cyclophosphamide; cyclosporin; etoposide; ganciclovir; immunoglobulin; methotrexate; steroid; tacrolimus; acute graft versus host disease; acute kidney failure; adolescent; adult; article; bone marrow transplantation; cancer chemotherapy; cancer radiotherapy; cancer recurrence; cancer risk; child; clinical article; controlled study; Cytomegalovirus; dialysis; disease free survival; donor selection; female; hemorrhagic cystitis; human; human cell; leukemia; male; myelodysplasia; sepsis; Taiwan; vein occlusion; virus infection; whole body radiation; bone marrow transplantation; graft versus host reaction; hematopoietic stem cell transplantation; leukemia; mortality; preschool child; recurrent disease; Adolescent; Bone Marrow Transplantation; Child; Child, Preschool; Female; Graft vs Host Disease; Hematopoietic Stem Cell Transplantation; Humans; Leukemia; Male; Recurrence
Type
journal article