Abstract
Allogeneic hematopoietic stem cell transplantation (HSCT) is a recognized method for treating children with a very high risk group for acute lymphoblastic leukemia (ALL) and a high risk group for acute myeloid leukemia (AML). The use of allogeneic HSCT for certain risk groups of acute leukemia significantly improves the survival of these patients compared to chemotherapeutic regimens. The aim of this study was to identify the causes of failure of HSC transplantation in children with acute leukemia in a homogeneous group of patients and the possibility of further improvement in survival rates. The study was approved by the Independent Ethics Committee and the Scientific Council of the Belarusian Research Center for Pediatric Oncology, Hematology and Immunology (Republic of Belarus). The study included 101 patients with ALL and 65 patients with AML who underwent the first HSCT, in accordance with the first-line treatment protocol or relapse for 2 consecutive time periods (1998–2008 and 2009–2018). For the entire group of patients, an increase in overall (by 13%) and event-free survival (by 7%) was revealed due to a decrease in post-transplant mortality not related to relapse by 16% (p = 0.077). Significant improvement in survival over time occurred in the group of patients with acute or chronic “graft versus host” disease. The data obtained indicate that all patients with acute leukemia who have indications for HSCT in the first line of treatment or relapse should be transplanted from any available donor, as this will significantly increase their chances of recovery.
Highlights
The use of allogeneic hematopoietic stem cell transplantation (HSCT) for certain risk groups of acute leukemia significantly improves the survival of these patients compared to chemotherapeutic regimens
The aim of this study was to identify the causes of failure of HSC transplantation in children with acute leukemia in a homogeneous group of patients and the possibility of further improvement in survival rates
The study was approved by the Independent Ethics Committee and the Scientific Council of the Belarusian Research Center for Pediatric Oncology, Hematology and Immunology (Republic of Belarus)
Summary
Аллогенная трансплантация гемопоэтических стволовых клеток при острых лейкозах у детей, подростков и молодых взрослых в Республике Беларусь. Аллогенная трансплантация гемопоэтических стволовых клеток (ТГСК) является общепризнанным методом лечения детей очень высокой группы риска острого лимфобластного лейкоза (ОЛЛ) и высокой группы риска острого миелобластного лейкоза (ОМЛ). Belarusian Research Center for Pediatric Oncology, Hematology and Immunology, Republic of Belarus. The study was approved by the Independent Ethics Committee and the Scientific Council of the Belarusian Research Center for Pediatric Oncology, Hematology and Immunology (Republic of Belarus). Аллогенная трансплантация гемопоэтических стволовых клеток (ТГСК) является общепризнанным методом лечения детей очень высокой группы риска острого лимфобластного лейкоза (ОЛЛ) и высокой группы риска острого миело бластного лейкоза (ОМЛ) [5, 6]. Цель данного ретроспективного исследования: сравнить результаты ТГСК у детей, подростков и молодых взрослых за 2 последовательных равных временных периода для выявления проблемных вопросов процедуры трансплантации и последующей их коррекции
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