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Outcomes of allogenic hematopoietic cell transplantation for childhood chronic myeloid leukemia: Single‐center experience
Author(s) -
Hafez Hanafy A.,
Abdallah Amr,
Hammad Mahmoud,
Hamdy Nayera,
Yassin Dina,
Salem Sherine,
Hassanain Omayma,
Elhalaby Lama,
Elhaddad Alaa
Publication year - 2020
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.13664
Subject(s) - medicine , busulfan , cyclophosphamide , hematopoietic stem cell transplantation , stem cell , bone marrow , single center , surgery , transplantation , chemotherapy , myeloid leukemia , retrospective cohort study , incidence (geometry) , oncology , physics , biology , optics , genetics
Background/objectives Despite the apparent efficacy and favorable toxicity profile of TKIs, allogeneic SCT remains the only curative treatment for CML especially in younger patients, but TRM should be considered. We evaluated the clinical outcomes of pediatric CML patients who had SCT in our center. Methods This retrospective study included children with CML, who received an allogeneic SCT at Children Cancer Hospital Egypt, 57357, from 2007 to 2017. All patients received myeloablative conditioning chemotherapy containing busulfan/cyclophosphamide followed by stem cell infusion from MRD. Results From 121 patients diagnosed with CML, 43 had available MRD and subjected to HSCT while 78 patients continued TKI therapy. The median time to transplant from diagnosis was 13 months. At initial diagnosis, there were 39 patients in CP and 4 had blastic crises. Bone marrow harvest was the stem cell source in 32 patients, while 11 cases received mobilized peripheral blood stem cells with average stem cell dose of 4.45 × 10 6 /kg. The probabilities of overall survival and event‐free survival at 5 years were 97.4% and 79.8%, respectively. TRM at 100 days and TRM at 1‐year post‐transplant were 0%. The incidence of chronic GVHD was significantly higher in peripheral blood than bone marrow stem cell source ( P = .004). Conclusion Considering the excellent survival rates and very low TRM, HSCT is still a valid option for pediatric patients with newly diagnosed CML with best using marrow stem cell source to avoid a significant risk of cGVHD and its related complications.