Improving outcomes of hematopoietic stem cell transplant for leukemia in children and young adults in resource-limited setting
Introduction: Allogeneic hematopoietic stem cell transplantation (HSCT) is a curative approach in patients with relapsed and high-risk leukemia. This retrospective analysis aimed to investigate outcomes and risk factors associated with HSCT in children and young adults with hematological malignancie...
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Elsevier,
2024-06-01T00:00:00Z.
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LEADER | 00000 am a22000003u 4500 | ||
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001 | doaj_f7f095c6730e481b96325090e965db8c | ||
042 | |a dc | ||
100 | 1 | 0 | |a Garima Nirmal |e author |
700 | 1 | 0 | |a Subhashish Paul |e author |
700 | 1 | 0 | |a Vaibhav Chadha |e author |
700 | 1 | 0 | |a Shreyasi Das |e author |
700 | 1 | 0 | |a Mohit Chaudhary |e author |
700 | 1 | 0 | |a Manju Joseph |e author |
700 | 1 | 0 | |a Bharti Sharma |e author |
700 | 1 | 0 | |a Himshikha Yadav |e author |
700 | 1 | 0 | |a K.K. Swathymon |e author |
700 | 1 | 0 | |a Iskandarov Kamol |e author |
700 | 1 | 0 | |a Gaurav Kharya |e author |
245 | 0 | 0 | |a Improving outcomes of hematopoietic stem cell transplant for leukemia in children and young adults in resource-limited setting |
260 | |b Elsevier, |c 2024-06-01T00:00:00Z. | ||
500 | |a 2468-1245 | ||
500 | |a 10.1016/j.phoj.2024.02.006 | ||
520 | |a Introduction: Allogeneic hematopoietic stem cell transplantation (HSCT) is a curative approach in patients with relapsed and high-risk leukemia. This retrospective analysis aimed to investigate outcomes and risk factors associated with HSCT in children and young adults with hematological malignancies in a resource-limited setting. Methods: We retrospectively evaluated 48 pediatric and young adult patients diagnosed with hematological malignancies who underwent HSCT at our institution between April 2017 and Jan 2023. Result: The median age of the cohort was 10 years (6 months - 21 years), and the majority of patients underwent transplants for acute lymphoblastic leukemia (ALL) (n = 24; 50 %) and acute myeloid leukemia (n = 18; 37.5%). Median time to neutrophil and platelet engraftment were 15 days (range 9-28) and 18 days (range 9-40), respectively. One patient had primary graft failure. Cytomegalovirus reactivation occurred in 21 patients (43.8%). Seventeen patients received escalated donor lymphocyte infusion (DLI). With a median follow-up of 902 days (52-2490), the probability of event free survival and overall survival (OS) was 65.9% and 69.4%. OS for lymphoid and myeloid malignancies were 64.7% and 75.2%, respectively. Kaplan-Meier probabilities of OS for patients in first complete remission (CR), CR2, CR3, or with refractory disease were 80%, 76.2%, 0%, and 40%, respectively (p = 0.02). OS of the patients undergoing matched sibling donor (n = 17) or haploidentical HSCT (n = 31) was 70.6% and 69%, respectively (p = 0.989). Conclusions: Our study demonstrates excellent outcomes of patients with hematological malignancies undergoing allogeneic HSCT with similar outcomes in HLA-identical sibling donors and haploidentical first-degree family donors. Prophylactic DLI might be considered in patients with high-risk leukemia to prevent relapse, including ALL. | ||
546 | |a EN | ||
690 | |a Hematological malignancies | ||
690 | |a Children | ||
690 | |a Young adults | ||
690 | |a ALL | ||
690 | |a AML | ||
690 | |a MRD | ||
690 | |a Pediatrics | ||
690 | |a RJ1-570 | ||
655 | 7 | |a article |2 local | |
786 | 0 | |n Pediatric Hematology Oncology Journal, Vol 9, Iss 2, Pp 105-113 (2024) | |
787 | 0 | |n http://www.sciencedirect.com/science/article/pii/S2468124524000111 | |
787 | 0 | |n https://doaj.org/toc/2468-1245 | |
856 | 4 | 1 | |u https://doaj.org/article/f7f095c6730e481b96325090e965db8c |z Connect to this object online. |