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KMID : 1130320080510010067
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Korean Journal of Pediatrics
2008 Volume.51 No. 1 p.67 ~ p.72
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Clinical outcomes of hematopoietic stem cell transplantation from HLA-matched parental donor in childhood acute leukemia
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Cha Eun-Young
Lee Moon-Hee
Lee Jae-Wook
Kwon Young-Joo
Lee Dae-Hyoung
Park Young-Shil
Chung Nack-Gyun
Jeong Chang-Mo
Cho Bin
Kim Hack-Ki
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Abstract
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Purpose: In this study, we retrospectively analyzed the clinical outcomes of patients who underwent allogeneic hematopoietic stem cell transplantation (HSCT) grafted from HLA-matched parents.
Methods: Seven children with acute leukemia (4 acute lymphoblastic leukemia, 3 acute myeloid leukemia) in first complete remission received allogeneic HSCT from their respective parents at the St. Marys Hospital between April, 1999 and October, 2005. The median age of patients at transplantation was 5 years (range, 1-11 years; 2 male, 5 female) and the median age of donors was 35 years (range, 30-41 years; 5 male, 2 female). We investigated the clinical outcomes such as engraftment, acute and chronic graft-versus-host disease (GVHD), transplant-related morbidity and mortality, relapse and survival.
Results: Median time from transplantation to last follow-up was 69.5 months (range, 18.8-96.5 months). All patients were successfully engrafted, with a median time of 11 days (range, 10-16 days) and 26 days (range, 13-39 days) for neutrophil and platelet recovery, respectively. Grade II acute GVHD occurred in 3, and grade III acute GVHD in 1 of 7 recipients. Extensive chronic GVHD developed in 2, and limited chronic GVHD in 1 of 7 recipients. Death from transplant-related complications occurred in 1, and relapse occurred in 1 of 7 recipients. Estimated 5-year overall survival was 83±15%.
Conclusions: The clinical outcomes of recipients who underwent HSCT from HLA-matched parents were comparable to those of patients who received HSCT grafted from HLA-matched sibling donors in childhood leukemia. HLA typing of parents, as well as siblings will increase the likelihood of finding an HLA-matched family donor for patients who need HSCT. (Korean J Pediatr 2008;51:67-72)
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KEYWORD
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Acute leukemia, Hematopoietic stem cell transplantation, HLA-matched parent
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