Excellent Outcomes of Hematopoietic Stem Cell Transplant for Pediatric High Risk and Relapsed Acute Myeloid Leukemia-A Decade Long Experience From Developing Nation.
[AIM] Hematopoietic stem cell transplant (HSCT) remains the cornerstone of treatment in patients with high-risk and relapsed acute myeloid leukemia (AML).
- p-value P =0.09
- 추적기간 40.9 months
APA
Arora S, Danewa AS, et al. (2026). Excellent Outcomes of Hematopoietic Stem Cell Transplant for Pediatric High Risk and Relapsed Acute Myeloid Leukemia-A Decade Long Experience From Developing Nation.. Journal of pediatric hematology/oncology, 48(1), 18-23. https://doi.org/10.1097/MPH.0000000000003151
MLA
Arora S, et al.. "Excellent Outcomes of Hematopoietic Stem Cell Transplant for Pediatric High Risk and Relapsed Acute Myeloid Leukemia-A Decade Long Experience From Developing Nation.." Journal of pediatric hematology/oncology, vol. 48, no. 1, 2026, pp. 18-23.
PMID
41359907
Abstract
[AIM] Hematopoietic stem cell transplant (HSCT) remains the cornerstone of treatment in patients with high-risk and relapsed acute myeloid leukemia (AML). In the absence of a fully matched donor, haploidentical HSCT is a feasible option. The aim of this study is to analyze the outcomes of pediatric AML patients, who underwent HSCT at our center.
[METHODS] This was a retrospective analysis of 48 pediatric patients who underwent 50 transplants at our center from January 2014 to December 2024.
[RESULTS] Median age at transplant was 8.5 years, and the male-to-female ratio was 1.9:1. Of 48 children, 46 patients had de novo AML, and 2 had secondary AML. Twenty-nine patients underwent matched sibling donor (MSD), 3 underwent matched related donor (MRD) and the remaining 18 received haploidentical HSCT. All patients received Fludarabine-based conditioning regimens and engrafted. Incidence of acute graft versus host disease (GVHD) in matched donor and haploidentical HSCT was 21.8% and 44.4%, respectively ( P =0.09). Incidence of chronic GVHD was 3.1% in matched donor and 5.5% in haploidentical HSCT ( P =0.72). Cumulative incidence of relapse was 16%. Viral reactivations were seen in 17 patients, cytomegalovirus (CMV) being the commonest. At a median follow-up of 40.9 months, EFS and OS of the overall cohort were 78% and 86%, respectively. Nonrelapse mortality (NRM) was 6%. EFS in matched donor and haploidentical HSCT was 78.1% versus 77.8% ( P =0.78). OS in matched donor and haploidentical HSCT was 84.4% versus 88.9% ( P =0.83). GVHD-free relapse-free survival (GRFS) was 58%. Among the factors analyzed, only pretransplant minimal residual disease (MRD) positivity was found to be associated with significantly poor outcome.
[CONCLUSION] HSCT for children with AML from the developing world shows promising outcomes with high survival rates even in the absence of matched donors. Having expertise in multiple specialties, such as a molecular hematologist, infectious disease (ID), and intensive care specialist, can significantly enhance the outcomes for transplant patients.
[METHODS] This was a retrospective analysis of 48 pediatric patients who underwent 50 transplants at our center from January 2014 to December 2024.
[RESULTS] Median age at transplant was 8.5 years, and the male-to-female ratio was 1.9:1. Of 48 children, 46 patients had de novo AML, and 2 had secondary AML. Twenty-nine patients underwent matched sibling donor (MSD), 3 underwent matched related donor (MRD) and the remaining 18 received haploidentical HSCT. All patients received Fludarabine-based conditioning regimens and engrafted. Incidence of acute graft versus host disease (GVHD) in matched donor and haploidentical HSCT was 21.8% and 44.4%, respectively ( P =0.09). Incidence of chronic GVHD was 3.1% in matched donor and 5.5% in haploidentical HSCT ( P =0.72). Cumulative incidence of relapse was 16%. Viral reactivations were seen in 17 patients, cytomegalovirus (CMV) being the commonest. At a median follow-up of 40.9 months, EFS and OS of the overall cohort were 78% and 86%, respectively. Nonrelapse mortality (NRM) was 6%. EFS in matched donor and haploidentical HSCT was 78.1% versus 77.8% ( P =0.78). OS in matched donor and haploidentical HSCT was 84.4% versus 88.9% ( P =0.83). GVHD-free relapse-free survival (GRFS) was 58%. Among the factors analyzed, only pretransplant minimal residual disease (MRD) positivity was found to be associated with significantly poor outcome.
[CONCLUSION] HSCT for children with AML from the developing world shows promising outcomes with high survival rates even in the absence of matched donors. Having expertise in multiple specialties, such as a molecular hematologist, infectious disease (ID), and intensive care specialist, can significantly enhance the outcomes for transplant patients.
MeSH Terms
Humans; Male; Female; Hematopoietic Stem Cell Transplantation; Child; Leukemia, Myeloid, Acute; Retrospective Studies; Adolescent; Child, Preschool; Graft vs Host Disease; Infant; Transplantation Conditioning; Survival Rate; Follow-Up Studies; Neoplasm Recurrence, Local
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