This site is intended for UK healthcare professionals
Medscape UK Univadis Logo
Medscape UK Univadis Logo
News

Paediatric therapy-related AML: high transplant-related mortality rate

Takeaway

  • Transplant-related mortality (TRM) is the main cause of death in children treated with haematopoietic stem cell transplantation for therapy-related acute myeloid leukaemia (t-AML).

Why this matters

  • The authors suggest the high incidence of TRM was caused by the heavily pre-treated status of the patients.
  • Potential measures such as reduction of salvage chemotherapy after achieving remission and a careful choice of conditioning regimen may be helpful in reducing TRM.
  • The authors are planning to prospectively examine if a reduced toxicity rather than a reduced intensity conditioning regimen could reduce TRM while preserving anti-leukaemic activity.

Key results

  • Median time from the original diagnosis to the diagnosis of t-AML was 3.8 yrs.
  • Majority (28 patients) received a graft from an unrelated donor.
  • Overall, 28 patients received myeloablative regimens and 6 received reduced intensity conditioning.
  • Survival outcome was available for 35 patients.
  • At median follow up of 7.3 yrs, 23 patients had died, giving a survival rate of 43%.
  • 13 of the 23 (56%) died from TRM and 10 (44%) died from disease relapse, giving an overall TRM rate of 37% and a relapse rate of 29%.  
  • Potential variables affecting survival were as follows t-AML secondary to solid tumour vs haematological/lymphoid malignancy; donor source; risk cytogenetics; and conditioning regimens.

Study design

  • Multi-centre retrospective study of 36 children who were diagnosed with t-AML and received HSCT in a dedicated Joint Accreditation Committee-ISCT & EBMT (JACIE) accredited paediatric UK transplant centre.
  • Funding: none specified.

Limitations

  • Survival model statistical analysis was not possible due to limited number of patients.


References


YOU MAY ALSO LIKE