Unrelated donor bone marrow transplantation in children and young adults with acute myeloid leukaemia in remission

• Published in: British journal of haematology 1997-10, Vol.99 (1), p.36-40
• Main Authors: Chown, Sally R., Marks, David I., Cornish, Jacqueline M., Pamphilon, Derwood H., Potter, Michael N., Steward, Colin G., Oakhill, Anthony
• Format: Article
• Language: English
• Subjects: acute myeloid leukaemia; Adolescent; Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; bone marrow transplantation; Bone Marrow Transplantation - methods; Bone marrow, stem cells transplantation. Graft versus host reaction; Child; Child, Preschool; Disease-Free Survival; Female; Graft vs Host Disease - etiology; graft‐versus‐host disease; Humans; Lymphocyte Depletion; Male; Medical sciences; Opportunistic Infections - complications; Precursor Cell Lymphoblastic Leukemia-Lymphoma - complications; Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy; Recurrence; Survival Analysis; Survival Rate; T-Lymphocytes; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Transplantation, Homologous; T‐cell depletion; unrelated donor; Virus Diseases - complications
• ISSN: 0007-1048; 1365-2141
• DOI: 10.1046/j.1365-2141.1997.3593173.x

The role of unrelated donor bone marrow transplantation (UD‐BMT) in the management of patients with acute myeloid leukaemia (AML) is uncertain. We describe 18 patients with a median age of 13 years (range 4–31) who received an ex vivo T‐cell‐depleted UD‐BMT for AML (13 in second complete remission (CR2) and five in first complete remission (CR1) with high‐risk features). Nine donor recipient pairs were fully matched; eight of these donor–recipient pairs had a single class I HLA mismatch; one patient had both single class I and class II HLA mismatches. Grade II GVHD of the skin occurred in four patients (22%) and limited chronic GVHD in two patients (11%). There have been four deaths: one from relapse and three from infection. With a median follow‐up of 27 months, 14 patients survive and the actuarial event‐free survival at 2 years is 70 ± 20% (95% confidence interval). We conclude that unrelated donor BMT can result in prolonged disease‐free survival in children and young adults with AML.