uu.seUppsala University Publications
Change search
ReferencesLink to record
Permanent link

Direct link
Outcomes of Allogeneic Hematopoietic Cell Transplantation in Children and Young Adults with Chronic Myeloid Leukemia: A CIBMTR Cohort Analysis
Ann & Robert H Lurie Childrens Hosp Chicago, Dept Pediat Hematol Oncol & Stem Cell Transplanta, 225 E Chicago Ave, Chicago, IL 60611 USA..
Med Coll Wisconsin, Dept Med, CIBMTR, Milwaukee, WI 53226 USA..
Med Coll Wisconsin, Dept Med, CIBMTR, Milwaukee, WI 53226 USA..
Univ S Florida, Coll Med, H Lee Moffitt Canc Ctr & Res Inst, Dept Blood & Marrow Transplantat, Tampa, FL 33612 USA..
Show others and affiliations
2016 (English)In: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 22, no 6, 1056-1064 p.Article in journal (Refereed) Published
Abstract [en]

Chronic myeloid leukemia (CML) in children and young adults is uncommon. Young patients have long life expectancies and low morbidity with hematopoietic cell transplantation (HCT). Prolonged tyrosine kinase inhibitor (TKI) use may cause significant morbidity. In addition, indication for HCT in patients in the first chronic phase is not established. We hence retrospectively evaluated outcomes in 449 CML patients with early disease receiving myeloablative HCT reported to the CIBMTR. We analyzed various factors affecting outcome, specifically the effect of age and pre-HCT TKI in pediatric patients (age < 18 years, n = 177) and young adults (age 18 to 29 years, n = 272) with the goal of identifying prognostic factors. Post-HCT probability rates of 5-year overall survival (OS) and leukemia-free survival (LFS) were 75% and 59%, respectively. Rates of OS and LFS were 76% and 57% in <18-year and 74% and 60% in 18- to 29-year group, respectively, by univariate analysis (P = .1 and = .6). Five-year rates of OS for HLA matched sibling donor (MSD) and bone marrow (BM) stem cell source were 83% and 80%, respectively. In multivariate analysis there was no effect of age (<18 versus 18 to 29) or pre-HCT TKI therapy on OS, LFS, transplant related mortality, or relapse. Favorable factors for OS were MSD (P < .001) and recent HCT (2003 to 2010; P = .04). LFS was superior with MSD (P < .001), BM as graft source (P = .001), and performance scores > 90 (P = .03) compared with unrelated or mismatched peripheral blood stem cells donors and recipients with lower performance scores. Older age was associated with increased incidence of chronic graft-versus-host disease (P = .0002). In the current era, HCT outcomes are similar in young patients and children with early CML, and best outcomes are achieved with BM grafts and MSD.

Place, publisher, year, edition, pages
2016. Vol. 22, no 6, 1056-1064 p.
Keyword [en]
CML, Pediatrics
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-302225DOI: 10.1016/j.bbmt.2016.02.015ISI: 000376814000014PubMedID: 26964698OAI: oai:DiVA.org:uu-302225DiVA: diva2:957111
Available from: 2016-09-01 Created: 2016-08-31 Last updated: 2016-09-01Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Olsson, Richard
By organisation
Centrum för klinisk forskning i Sörmland (CKFD)
In the same journal
Biology of blood and marrow transplantation
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 2 hits
ReferencesLink to record
Permanent link

Direct link