Archivos de Pediatría del Uruguay
versión impresa ISSN 0004-0584
DUFORT Y ALVAREZ, Gustavo et al. Resultados del tratamiento de la leucemia aguda mieloblástica del niño con trasplante de progenitores hematopoyéticos en primera remisión. Arch. Pediatr. Urug. [online]. 2009, vol.80, n.2, pp. 90-98. ISSN 0004-0584.
Background: the survival of children with acute myeloid leukemia has improved in the last decades. Aggressive induction chemotherapy and postremission treatment are important for optimal results. Several groups have investigated the utility of allogeneic and autologous hematopoyetic stem cell transplantation in first remission. The main objective of this study was to evaluate the results obtained with HSCT, either allogenic o autologous, following two intensive consolidation courses. Patients and methods: from January 1997 to December 2006, 31 children (< 15 years old) with de novo AML were prospectively enrolled in the protocol AML-CHPR. After one or two induction courses, all patients who achieved complete remission (CR) received two consolidations. Then they were submitted to allogeneic HSCT if a compatible family donor was present or autologous HSCT if there wasn´t. Results: twenty nine patients (93,6%) achieved CR after one (n=26) or two (n=3) courses of induction treatment. Two patients had an early death. Four patients had treatment related mortality (TRM) due to fatal infections during the chemotherapy phase. The 25 patients who entered in the transplant phase, 24 underwent a HSCT; four allogeneic and 20 autologous. There was no transplant related mortality. Six patients relapsed, all in the autologous group, and four of these died due to the disease progression. Two patients were rescued with a second transplant from a haploidentical donor. 10 year - overall survival (OS) after transplant and event free survival (EFS) were 73,5% ± 9,4 and 64,5% ± 10,2% respectively. OS and EFS in all the series (31 patients) were 56,6% ± 9,2 y 50% ± 9,0 respectively, with a median follow-up of 56 months. Conclusions: due to the limited number of patients our results are not comparable with most of the important clinical trials published. However, allogenic and autologous HSCT were an effective postremission treatment without transplant related mortality.
Palabras llave : LEUKEMIA, MYELOID, ACUTE; HEMATOPOIETIC STEM CELL; TRANSPLANTATION, HOMOLOGOUS; TRANSPLANTATION, AUTOLOGOUS.