Outcomes of children, adolescents, and young adults following allogeneic stem cell transplantation for secondary acute myeloid leukemia and myelodysplastic syndromes—The MD Anderson Cancer Center experience
Corresponding Author
Ossama M. Maher
Pediatrics, University of Texas MD Anderson Cancer Center, Houston, TX, USA
Department of Pediatrics, National Cancer Institute, Cairo University, Cairo, Egypt
Correspondence
Ossama M. Maher, Pediatrics, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Email: [email protected]
and
Priti Tewari, Pediatric Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Email: [email protected]
Search for more papers by this authorJorge Galvez Silva
Pediatrics, University of Texas MD Anderson Cancer Center, Houston, TX, USA
Search for more papers by this authorJimin Wu
Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, TX, USA
Search for more papers by this authorDiane Liu
Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, TX, USA
Search for more papers by this authorLaurence J.N. Cooper
Pediatric Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, TX, USA
Search for more papers by this authorNidale Tarek
Pediatric Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, TX, USA
Search for more papers by this authorLaura Worth
Pediatric Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, TX, USA
Search for more papers by this authorDean A. Lee
Pediatric Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, TX, USA
Search for more papers by this authorDemetrios Petropoulos
Pediatric Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, TX, USA
Search for more papers by this authorAnna R.K. Franklin
Pediatrics, University of Texas MD Anderson Cancer Center, Houston, TX, USA
Search for more papers by this authorPatrick Zweidler-Mckay
Pediatrics, University of Texas MD Anderson Cancer Center, Houston, TX, USA
Search for more papers by this authorRobert J. Wells
Pediatrics, University of Texas MD Anderson Cancer Center, Houston, TX, USA
Search for more papers by this authorGabriela Rondon
Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, TX, USA
Search for more papers by this authorRichard E. Champlin
Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, TX, USA
Search for more papers by this authorCorresponding Author
Priti Tewari
Pediatric Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, TX, USA
Correspondence
Ossama M. Maher, Pediatrics, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Email: [email protected]
and
Priti Tewari, Pediatric Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Email: [email protected]
Search for more papers by this authorCorresponding Author
Ossama M. Maher
Pediatrics, University of Texas MD Anderson Cancer Center, Houston, TX, USA
Department of Pediatrics, National Cancer Institute, Cairo University, Cairo, Egypt
Correspondence
Ossama M. Maher, Pediatrics, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Email: [email protected]
and
Priti Tewari, Pediatric Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Email: [email protected]
Search for more papers by this authorJorge Galvez Silva
Pediatrics, University of Texas MD Anderson Cancer Center, Houston, TX, USA
Search for more papers by this authorJimin Wu
Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, TX, USA
Search for more papers by this authorDiane Liu
Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, TX, USA
Search for more papers by this authorLaurence J.N. Cooper
Pediatric Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, TX, USA
Search for more papers by this authorNidale Tarek
Pediatric Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, TX, USA
Search for more papers by this authorLaura Worth
Pediatric Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, TX, USA
Search for more papers by this authorDean A. Lee
Pediatric Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, TX, USA
Search for more papers by this authorDemetrios Petropoulos
Pediatric Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, TX, USA
Search for more papers by this authorAnna R.K. Franklin
Pediatrics, University of Texas MD Anderson Cancer Center, Houston, TX, USA
Search for more papers by this authorPatrick Zweidler-Mckay
Pediatrics, University of Texas MD Anderson Cancer Center, Houston, TX, USA
Search for more papers by this authorRobert J. Wells
Pediatrics, University of Texas MD Anderson Cancer Center, Houston, TX, USA
Search for more papers by this authorGabriela Rondon
Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, TX, USA
Search for more papers by this authorRichard E. Champlin
Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, TX, USA
Search for more papers by this authorCorresponding Author
Priti Tewari
Pediatric Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, TX, USA
Correspondence
Ossama M. Maher, Pediatrics, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Email: [email protected]
and
Priti Tewari, Pediatric Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Email: [email protected]
Search for more papers by this authorFunding information
No external funding was secured for this study.
Abstract
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).
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