Cancer research and treatment · 2026
Total Body Irradiation, Busulfan, Fludarabine Conditioning for Pediatric Acute Myeloid Leukemia Patients Treated with Hematopoietic Stem Cell Transplantation in Second Complete Remission.
СтатьяНазвание и аннотация: Перевод в очереди
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Lee Jae Wook, Jo Suejung, Yoo Jae Won, Kim Seongkoo, Chung Nack-Gyun, Cho Bin
Аннотация
PURPOSE: The optimum conditioning regimen for pediatric acute myeloid leukemia (AML) patients who receive allogeneic hematopoietic stem cell transplantation (HSCT) in second complete remission (CR) remains unclear. In this study, we reviewed the outcome of AML patients treated with HSCT in second CR at our institution, focusing on the role of the conditioning regimen on post-transplant survival.
MATERIALS AND METHODS: We evaluated 43 AML patients who received myeloablative HSCT in second CR at our institution from 2009 to 2023. Thirteen of the patients (30.2%) received conditioning with busulfan and fludarabine (Bu/Flu), while 30 patients (69.8%) were treated with total body irradiation (TBI) 8 Gray combined with Bu and Flu (TBI/Bu/Flu).
RESULTS: Thirty-two of the patients received a haploidentical family donor (HFD) transplant (74.4%). Estimated 5-year event-free survival (EFS) was 57.5±7.6% (24/43), with 5-year cumulative incidence of relapse and non-relapse mortality of 30.7±7.2% and 11.8±5.0% respectively. Among risk factors for EFS, only the conditioning regimen was important with patients treated with TBI/Bu/Flu having significantly higher 5-year EFS than those who received Bu/Flu (73.0±8.2% vs. 23.1±11.7%, p=0.004). There was no significant difference in 5-year EFS between patients who received HFD transplant, and those treated with transplant from other donors. Estimated 5-year OS was 66.8±7.3% (28/43), with all 28 surviving patients remaining disease-free at last follow-up.
CONCLUSION: A myeloablative TBI/Bu/Flu regimen resulted in 5-year EFS of 73.0±8.2%, indicating favorable long-term outcome for AML patients in second CR who receive HSCT with this conditioning regimen compared to previous studies.
MATERIALS AND METHODS: We evaluated 43 AML patients who received myeloablative HSCT in second CR at our institution from 2009 to 2023. Thirteen of the patients (30.2%) received conditioning with busulfan and fludarabine (Bu/Flu), while 30 patients (69.8%) were treated with total body irradiation (TBI) 8 Gray combined with Bu and Flu (TBI/Bu/Flu).
RESULTS: Thirty-two of the patients received a haploidentical family donor (HFD) transplant (74.4%). Estimated 5-year event-free survival (EFS) was 57.5±7.6% (24/43), with 5-year cumulative incidence of relapse and non-relapse mortality of 30.7±7.2% and 11.8±5.0% respectively. Among risk factors for EFS, only the conditioning regimen was important with patients treated with TBI/Bu/Flu having significantly higher 5-year EFS than those who received Bu/Flu (73.0±8.2% vs. 23.1±11.7%, p=0.004). There was no significant difference in 5-year EFS between patients who received HFD transplant, and those treated with transplant from other donors. Estimated 5-year OS was 66.8±7.3% (28/43), with all 28 surviving patients remaining disease-free at last follow-up.
CONCLUSION: A myeloablative TBI/Bu/Flu regimen resulted in 5-year EFS of 73.0±8.2%, indicating favorable long-term outcome for AML patients in second CR who receive HSCT with this conditioning regimen compared to previous studies.