Retrospective analysis of children with high-risk acute myeloid leukemia who underwent allogeneic hematopoietic stem cell transplantation following complete remission with initial induction chemotherapy in the AML-05 clinical trial

Nobuyuki Hyakuna, Yoshiko Hashii, Hiroyuki Ishida, Katsutsugu Umeda, Yoshiyuki Takahashi, Masayuki Nagasawa, Hiromasa Yabe, Yozo Nakazawa, Katsuyoshi Koh, Hiroaki Goto, Hiroyuki Fujisaki, Kimikazu Matsumoto, Harumi Kakuda, Michihiro Yano, Akio Tawa, Daisuke Tomizawa, Takashi Taga, Souichi Adachi, Koji Kato

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3 Citations (Scopus)

Abstract

In the AML-05 clinical trial conducted by the Japanese Pediatric Leukemia/Lymphoma Group from 2006 to 2010, children with high-risk acute myeloid leukemia (HR AML) received allogeneic hematopoietic stem cell transplantation (allo-HSCT) at first complete remission (CR1). The aim of this study was to investigate the impact of allo-HSCT on the outcome of HR AML. Patients with either monosomy 7, 5q−, t(16;21), Ph1, FLT3-ITD, or induction failure after the first course of chemotherapy were eligible for transplant. Of 53 children with HR AML, 51 received allo-HSCT—45 in CR1, five in CR2, and one with non-CR. t(8;21), t(9;11), and t(16;21) abnormalities were identified in eight, five, and four patients, respectively. The stem cell sources varied—bone marrow in 30 patients, peripheral blood in three, and cord blood in 18. The median follow-up was 62 months. The overall survival (OS) rates at 3 years were 73% and 25% for patients who received transplant at CR1 and ≥CR2, respectively. Multivariable analysis showed that patients with chronic graft-versus-host disease (cGVHD) had better OS. This study supports that allo-HSCT is a suitable treatment for HR AML in CR1. The favorable outcome associated with cGVHD indicates that a graft-versus-leukemia effect might be occurring.

Original languageEnglish
Article numbere27875
JournalPediatric Blood and Cancer
Volume66
Issue number10
DOIs
Publication statusPublished - 2019

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

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