Autologous Peripheral Blood Hematopoietic Stem Cell Transplantation for Children with Acute Myelogenous Leukemia in Korea / 대한소아혈액종양학회지

ABSTRACT

PURPOSE: Autografts with peripheral blood stem cells (PBSCT) have become an accepted alternative to bone marrow transplantation for restoring hematopoiesis after marrow ablative therapy. METHODS: Questionnaires are given to all the transplantation centers in Korea. Eleven centers reported 63 cases and retrospective analysis of these cases were done. RESULTS: Sixty-three children with acute myelogenous leukemia (AML) underwent PBSCT following cytoreductive chemotherapy at 11 transplant centers of the Korean Society of Pediatric Hematology-Oncology from January, 1996 through June, 2000. The patients consisted of 40 males and 23 females with a median age at PBSCT of 10 year (range 1~16). Peripheral blood stem cell (PBSC) were collected by a median of 5 apheresis per patient. Various kinds of multi-drug therapy as cytoreductive regimen were used, and the 'BCVAC' regimen consisting of BCNU, cyclophosphamide, VP-16 and cytarabine was used in 35 patients. The median number of infused mononuclear cell (MNC) and CD34 cells was 8.14 (0.3~26.6) 108/kg and 4.90 (0.12~46.9) 106/kg, respectively. Hematological recovery was evaluated in all patients. The median number of days required to achieve an absolute neutrophil count (ANC) of > 500/mm3, > 1,000/mm3 and platelet count of > 50 103/mm3 was 12 (8~48), 12 (9~84) and 35 (10~370), respectively. Sixteen patients relapsed 1 month to 18 months (median 2 months) after PBSCT, 1 patient progressed to secondary MDS 15 months after PBSCT and 1 patient died at d+39 due to CMV infection. So currently 45 patients are surviving disease free at 2 to 50 months (median 23 months). CONCLUSION: Even though the follow-up period was short and the number of patient was small the autologous PBSCT might be an alternative therapy in childhood AML.