Comparison of survival outcome between donor types or stem cell sources for childhood acute myeloid leukemia after allogenic hematopoietic stem cell transplantation: A multicenter retrospective study of Study Alliance of Yeungnam Pediatric Hematology‐oncology

Abstract

We compared transplant outcomes between donor types and stem cell sources for childhood acute myeloid leukemia (AML). The medical records of children with AML in the Yeungnam region of Korea from January 2000 to June 2017 were reviewed. In all, 76 children with AML (male-to-female ratio = 46:30) received allogenic hematopoietic stem cell transplantation (allo-HSCT). In total, 29 patients received HSCT from either a matched-related donor or a mismatched-related donor, 32 patients received an unrelated donor, and 15 patients received umbilical cord blood. In term of stem cell sources, bone marrow was used in 15 patients and peripheral blood in 46 patients. For all HSCT cases, the 5-year overall survival (OS) was 73.1% (95% CI: 62.7-83.5) and the 5-year event-free survival (EFS) was 66.1% (95% CI: 54.5-77.7). There was no statistical difference in 5-year OS according to the donor types or stem cell sources (P = .869 and P = .911). There was no statistical difference in 5-year EFS between donor types or stem cell sources (P = .526 and P = .478). For all HSCT cases, the 5-year relapse rate was 16.1% (95% CI: 7.3-24.9) and the 5-year non-relapse mortality (NRM) was 13.3% (95% CI: 5.1-21.5). There was no statistical difference in the 5-year relapse rate according to the donor types or stem cell sources (P = .971 and P = .965). There was no statistical difference in the 5-year NRM between donor types or stem cell sources (P = .461 and P = .470).

Immunology of cord blood T-cells favors augmented disease response during clinical pediatric stem cell transplantation for acute leukemia

“…This has also been reported in children receiving T-replete CBT for myeloid malignancy with an increased rate of TRM compared to a comparator arm (hazard ratio 2.04; p = 0.042) (3). Other studies, however, have produced conflicting data with no significant increase in TRM detected with CBT (38,40,[45][46][47][48]. Heterogeneity of patient populations, disease groups, conditioning regimens, particularly the use of T-depleting serotherapy and outcome measures confounds direct comparison of these studies.…”

Treatment Outcomes of Pediatric Acute Myeloid Leukemia in the Yeungnam Region: A Multicenter Retrospective Study of the Study Alliance of Yeungnam Pediatric Hematology–Oncology (SAYPH)

“…According to the cytogenetics data, the survival outcome of chemotherapy and HSCT did not show any significant difference. In addition, in a previous study, we had reported that there is no difference in the survival outcome based on donor type and stem cell source after allogenic HSCT [ 14 ].…”

In Vitro Expansion of Anti-viral T Cells from Cord Blood by Accelerated Co-cultured Dendritic Cells

“…For the many patients who lack a suitable HLA (human leukocyte antigen)-matched donor, the use of alternative donors—i.e., mismatched unrelated donors, unrelated cord blood (CB) donors, and haplo-identical family donors—has extended the possibility of hematopoietic stem cell transplantation (HSCT) 1 . The use of CB has some major advantages: it can be more readily available; it tolerates some degree of HLA mismatch, which greatly helps in finding suitable CB units; and it yields a reduced risk of graft-versus-host disease (GvHD) and relapse 2 .…”