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Hematopoietic Stem Cell Transplantation in Children with Leukemia: A Single Institution Experience with Respect to Donors
Article in En | WPRIM | ID: wpr-227751
Responsible library: WPRO
ABSTRACT
Aim of this study was to compare the outcomes of transplantation by donor source and to help select the best alternative donor in children with leukemia. Donor sources included matched related donor (MRD, n = 35), allele-matched unrelated donor (M-UD, n = 10) or -mismatched (MM)-UD (n = 13) or unrelated umbilical cord blood (UCB, n = 11). UCB group had a significantly higher incidence of grade II-IV acute graft versus host disease (MRD, 11.8%; M-UD, 30.0%; MM-UD, 15.4%, UCB, 54.4%, P = 0.004) but there was no difference in incidence of chronic graft versus host disease between 4 groups. The 5-yr leukemia-free survival (LFS) was 76.7%, 60.0%, 69.2%, and 45.5%, respectively (P = 0.128). MRD group showed higher LFS rate than UCB group (P = 0.022). However, LFS of M-UD and MM-UD together (65.2%) was not different from that of MRD group (76.7%, P = 0.325), or from that of UCB (45.5%, P = 0.190). The relapse incidence at 5 yr was 17.1%, 20.0%, 15.4%, and 0%, respectively (P = 0.460). The 100-day treatment-related mortality was 2.9%, 20.0%, 7.7%, and 36.4%, respectively (P = 0.011). Despite the limitations of small number of patients, unrelated donor transplants including even allele-mismatched ones, seem to be as effective in children with leukemia lacking suitable relative donors. Also, UCB transplant may serve as another possible option in urgent transplants.
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Full text: 1 Index: WPRIM Main subject: Transplantation, Homologous / Histocompatibility Testing / Leukemia / Treatment Outcome / Hematopoietic Stem Cell Transplantation / Disease-Free Survival / Graft vs Leukemia Effect / Cord Blood Stem Cell Transplantation / Fetal Blood / Unrelated Donors Limits: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male Language: En Journal: Journal of Korean Medical Science Year: 2011 Type: Article
Full text: 1 Index: WPRIM Main subject: Transplantation, Homologous / Histocompatibility Testing / Leukemia / Treatment Outcome / Hematopoietic Stem Cell Transplantation / Disease-Free Survival / Graft vs Leukemia Effect / Cord Blood Stem Cell Transplantation / Fetal Blood / Unrelated Donors Limits: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male Language: En Journal: Journal of Korean Medical Science Year: 2011 Type: Article