Favorable outcomes of unrelated cord blood transplant for pediatric acute myeloid leukemia in Hong Kong

Abstract

PURPOSE/OBJECTIVE: We aimed to review and compare the outcomes of children with acute myeloid leukemia (AML) who received allogeneic hematopoietic stem cell transplant (HSCT) from different types of donors. MATERIALS AND METHODS: We performed a retrospective review of the patient and transplant characteristics and transplant outcomes of children with AML who underwent allogeneic HSCT in our unit. RESULTS: We performed allogeneic HSCT for 42 children (26 males and 16 females) with AML in 1994-2012. The median age at HSCT was 9.2 years (range, 0.8 to 18.5 years). Sixteen children were transplanted in first complete remission, 19 in second remission, 1 in third remission, and 6 with non-remission. Donors were matched sibling (MS) (n ? 17), 1-antigen mismatched parent (MP) (n ? 2), matched unrelated donor (MUD) (n ? 11), or 4-6/6 HLA-matched unrelated cord blood (UCB) (n ? 12). Five-year overall survival (OS) and relapse-free survival (RFS) were better in patients who received UCB compared to MS, MUD, or MP (OS: 76.2% vs. 32.4% vs. 18.2% vs. 0%; RFS: 71.4% vs. 32.7% vs. 18.2% vs. 0%). The differences in OS and RFS among different types of donors were statistically significant after adjusting for age and remission status (p ? 0.007 for OS and p ? 0.037 for RFS). Transplant-related mortalities in UCB, MS, MUD, and MP were 0%, 17.6%, 72.7% and 50% respectively. CONCLUSIONS: Outcomes were favorable for pediatric AML patients who received unrelated cord blood transplant compared to other types of donors in our unit.