Maher Ossama M, Silva Jorge Galvez, Wu Jimin, Liu Diane, Cooper Laurence J N, Tarek Nidale, Worth Laura, Lee Dean A, Petropoulos Demetrios, Franklin Anna R K, Zweidler-Mckay Patrick, Wells Robert J, Rondon Gabriela, Champlin Richard E, Tewari Priti
Pediatrics, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Department of Pediatrics, National Cancer Institute, Cairo University, Cairo, Egypt.
Pediatr Transplant. 2017 May;21(3). doi: 10.1111/petr.12890. Epub 2017 Feb 3.
We conducted a retrospective analysis of outcomes for children and young adults with sAML/sMDS who underwent HSCT at our institution. Thirty-two patients (median age 20 years) with sAML (n=24) and sMDS (n=8) received HSCT between 1990 and 2013. The median time from sAML/sMDS diagnosis to HSCT was 4.1 months (range: 1.2-27.2 months). The transplant regimens were primarily busulfan based (n=19). BM was the primary donor source (n=15). Eleven recipients were transplanted with residual disease. At a median follow-up of 62.3 months (range: 0.4-250.9 months), 14 patients had disease recurrence. Acute GVHD, grade III/IV, occurred in three patients. Causes of death were as follows: disease relapse (n=12), infection (n=2), pneumonia (n=1), pulmonary hemorrhage (n=1), acute GVHD (n=1), and graft failure (n=1). A PS of ≥90% at the time of HSCT had a significant impact on PFS (P=.02). Patients achieving pretransplant primary CR (n=8) and those with sMDS and RA (n=6) had prolonged PFS (P=.04). On multivariate analysis, shorter time to transplantation (≤6 months from diagnosis of sAML/sMDS) was associated with superior OS (P=.0018) and PFS (P=.0005).
