Study Progress of Hematopioetic Stem Cell Transplantation Therapy on Acute Leukemia in Children / 实用儿科临床杂志

ABSTRACT

Hematopoietic stem cell transplantation(HSCT) is one of the measures therapy on acute leukemia in children.Very-high-risk children with acute lymphocytic leukemia (ALL),such as Philadelphia chromosome-positive(Ph+),T cell immunophenotype,achieved the first complete remission(CR1),and then receive allogeneic HSCT(allo-HSCT).The transplantation group had significantly improved disease-free survival(DFS)and overall survival(OS) compared with chemotherapy group. ALL children in the second complete remission(CR2) were recommended to receive allo-HSCT,especially early-relapse group. All children in the third complete remission (CR3) were recommended to receive an allo-HSCT,and reduce replapse rate through inducing graft versus leukemia.Total body irradiation-based conditioning regimens in children with ALL has advantage over chemotherapy conditioning regimens.Children with acute myeloblastic leukemia (AML) achieved CR1 and then undergo all-HSCT.This group had significantly improved DFS and OS compared with chemotherapy group.The children with relapsed AML,if having suitable donor,were recommended to receive allo-HSCT. The children with AML who underwent transplantation relapse,and can receive the second transplantation.There was no advantage in children patients with AML using TBI-based conditioning regimens.Conditioning regimens consisted of high-dose cytarabine,in combination with granulocyte colony-stimulating factor has advantage,and improve DFS. Unrelated umbilical cord blood has emerged as a potential option.Compared with unrelated bone marrow transplantation,there was no different in DFS and relapse.For the extent,it is one of the donor hematopoietic stem cell sources.