Premium
Allogeneic hematopoietic cell transplantation in chemotherapy‐induced aplasia in children with high‐risk acute myeloid leukemia or myelodysplasia
Author(s) -
Kussman Ashleigh,
Shyr David,
Hale Gregory,
Oshrine Benjamin,
Petrovic Aleksandra
Publication year - 2019
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.27481
Subject(s) - medicine , clofarabine , myeloid leukemia , aplasia , bone marrow aplasia , cytarabine , chemotherapy , refractory (planetary science) , transplantation , hematopoietic stem cell transplantation , myeloid , leukemia , hematopoietic cell , oncology , disease , haematopoiesis , bone marrow , stem cell , physics , astrobiology , biology , genetics
Abstract Relapse remains the most common cause of treatment failure after hematopoietic cell transplantation for acute myeloid leukemia. Inability to achieve hematologic complete remission has been a barrier to transplant for patients with refractory disease. We describe six children with refractory myeloid disease undergoing transplant in chemotherapy‐induced aplasia, as a strategy to facilitate curative therapy in refractory patients. Clofarabine‐ or high‐dose cytarabine‐based chemotherapy regimens were used to achieve marrow aplasia, followed by reduced‐intensity conditioning and allogeneic transplant before hematologic recovery. Long‐term disease control was achieved in five, with one transplant‐related mortality, suggesting the feasibility of this approach.