NYMC Faculty Publications
Outcome of Transplantation for Acute Myelogenous Leukemia in Children With Down Syndrome
Author Type(s)
Faculty
DOI
10.1016/j.bbmt.2013.02.017
Journal Title
Biology of Blood and Marrow Transplantation
First Page
893
Last Page
897
Document Type
Article
Publication Date
6-1-2013
Department
Pediatrics
Keywords
Adolescent, Antineoplastic Agents, Bone Marrow Transplantation, Child, Child, Preschool, Down Syndrome, Female, Graft vs Host Disease, Hematopoietic Stem Cell Transplantation, Humans, Leukemia, Myeloid, Acute, Male, Recurrence, Remission Induction, Risk Factors, Survival Analysis, Transplantation, Homologous, Treatment Outcome, Young Adult
Disciplines
Medicine and Health Sciences | Oncology | Pediatrics
Abstract
Data on outcomes of allogeneic transplantation in children with Down syndrome and acute myelogenous leukemia (DS-AML) are scarce and conflicting. Early reports stress treatment-related mortality as the main barrier; a recent case series points to posttransplantation relapse. We reviewed outcome data for 28 patients with DS-AML reported to the Center for International Blood and Marrow Transplant Research between 2000 and 2009 and performed a first matched-pair analysis of 21 patients with DS-AML and 80 non-DS AML controls. The median age at transplantation for DS-AML was 3 years, and almost half of the cohort was in second remission. The 3-year probability of overall survival was only 19%. In multivariate analysis, adjusting for interval from diagnosis to transplantation, risks of relapse (hazard ratio [HR], 2.84; P < .001; 62% versus 37%) and transplant-related mortality (HR, 2.52; P = .04; 24% versus 15%) were significantly higher for DS-AML compared to non-DS AML. Overall mortality risk (HR, 2.86; P < .001; 21% versus 52%) was significantly higher for DS-AML. Both transplant-related mortality and relapse contribute to higher mortality. Excess mortality in DS-AML patients can only effectively be addressed through an international multicenter effort to pilot strategies aimed at lowering both transplant-related mortality and relapse risks.
Recommended Citation
Hitzler, J., He, W., Doyle, J., Cairo, M., Camitta, B., Chan, K., Diaz Perez, M., Fraser, C., Gross, T., Horan, J., Kennedy-Nasser, A., Kitko, C., Kurtzberg, J., Lehmann, L., O'Brien, T., Pulsipher, M., Smith, F., Zhang, M., Eapen, M., & Carpenter, P. (2013). Outcome of Transplantation for Acute Myelogenous Leukemia in Children With Down Syndrome. Biology of Blood and Marrow Transplantation, 19 (6), 893-897. https://doi.org/10.1016/j.bbmt.2013.02.017
