AlloHSCT in paediatric ALL and AML in complete remission: improvement over time impacted by accreditation?
Adolescent
Adult
Allografts
Child
Child, Preschool
Disease-Free Survival
Female
Hematopoietic Stem Cell Transplantation
Humans
Infant
Leukemia, Myeloid, Acute
/ mortality
Male
Precursor Cell Lymphoblastic Leukemia-Lymphoma
/ mortality
Recurrence
Remission Induction
Retrospective Studies
Risk Factors
Survival Rate
Journal
Bone marrow transplantation
ISSN: 1476-5365
Titre abrégé: Bone Marrow Transplant
Pays: England
ID NLM: 8702459
Informations de publication
Date de publication:
05 2019
05 2019
Historique:
received:
15
02
2018
accepted:
29
08
2018
revised:
28
08
2018
pubmed:
28
9
2018
medline:
2
7
2020
entrez:
28
9
2018
Statut:
ppublish
Résumé
Allogeneic hematopoietic stem cell transplantation (alloHSCT) has become a well-established treatment option for many patients suffering from malignant and non-malignant diseases. In the past decade, high-resolution HLA-typing, remission surveillance, pre-emptive immune intervention, and standardisation in supportive care measures have substantially improved transplant outcomes. This retrospective study evaluated transplant procedures in 162 paediatric patients with acute lymphoblastic leukaemia (n = 124) or acute myeloid leukaemia (n = 38) who received their first alloHSCT in our institution over an 11-year period. We observed a significant reduction in risk of non-relapse mortality (NRM) over time (HR = 0.34, 95% CI 0.12-0.98; P = 0.05), the 4-year NRM estimate decreased from 20% in 2005-2008 to 7% in 2012-2016 (P = 0.02) and an increase in survival after relapse. There was no significant difference in patients who received a graft from a sibling, haplo, or an unrelated donor with regard to their overall survival (P = 0.45), event-free survival (P = 0.61), and non-relapse mortality (P = 0.19). Our data suggest that a specific transplant infrastructure with a highly experienced team in an accredited transplant centre likely contributes to better transplant outcomes for acute leukaemia patients in complete remission regardless of donor type.
Identifiants
pubmed: 30258130
doi: 10.1038/s41409-018-0341-z
pii: 10.1038/s41409-018-0341-z
doi:
Types de publication
Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
737-745Références
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