Allogeneic bone marrow transplantation for chronic myelomonocytic leukemia in childhood: a report from the European Working Group on Myelodysplastic Syndrome in Childhood.

Abstract

Children with CMML and an HLA-compatible relative should be transplanted as early as possible. Improvement of donor selection, GVHD prophylaxis, and supportive care are needed to ameliorate results of BMT from alternative donors.

Allogeneic bone marrow transplantation for juvenile myelomonocytic leukemia: a single center experience of 23 patients

“…Intensive chemotherapy given before the start of the conditioning for BMT had a significant adverse effect (P ¼ 0.04 in univariate analysis) in our study on the relapse rate after BMT. This finding is not in agreement with the findings of other authors 11,14,22 and needs further study. The influence of TBI in the conditioning regimen for JMML was studied by Matthes-Martin et al 22 in a single center evaluation of 11 transplants and a review of the literature on single center reports.…”

“…Although the only curative approach for JMML is to perform an allogeneic BMT, 2,[11][12][13] this procedure is accompanied by a high relapse rate and a high TRM, resulting in an OS of 31-58% as reported in the recent literature. 8,10,11,14,15 In our series, OS is 43.5710% at 5 and 10 years; the probability of relapse-free survival (TRM censured) is 48712%.…”

“…8,10,11,14,15 In our series, OS is 43.5710% at 5 and 10 years; the probability of relapse-free survival (TRM censured) is 48712%. Rapid sustained engraftment in 20 of 22 evaluable children proved that engraftment was not a problem, similar to results in other studies.…”

“…Rapid sustained engraftment in 20 of 22 evaluable children proved that engraftment was not a problem, similar to results in other studies. 14,15,17,22 Factors possibly predicting a relapse, as found by us and by others, relate to karyotype, 14 intensive pre-BMT chemotherapy, conditioning regimen, 11,22 donor type, 11 TCD and GvHD. 15 Manabe et al 14 found in a multivariate analysis on the outcome of 27 JMML patients an abnormal karyotype to be the only significant risk factor for decreased OS.…”

“…9,10 Allogeneic BMT has been shown to improve outcome: retrospective evaluations of series including 15 patients or more reported an overall survival (OS) of 39-58%. 2,[11][12][13][14][15] Woods 10 found a similar OS at 6 years of 31% for 13 patients treated on a prospective study (CCG protocol 2891). The major causes of failure in all series were a high relapse rate and a high transplant-related mortality (TRM).…”