| One Hundred Cases of HLA-matched Sibling Allogeneic bone Marrow Transplantation in Children : Single Center Study |
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Hack Ki Kim1, Bin Cho1, Nak Gyun Chung1, Dae Chul Jeong1, Soh Yeon Kim1, Hyun Jung Lee1, Kyong Su Lee1, Kyung Ja Han2, Won Il Kim2, Il Bong Choi3, Chun Choo Kim4 |
1Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
2Department of Clinical Pathology, College of Medicine, The Catholic University of Korea,
3Department of Therapeutic Radiology, College of Medicine, The Catholic University of Korea
4The Catholic Hematopoietic Stem Cell Transplantation Center, Seoul, Korea |
| 소아 동종 골수이식 100례의 분석 |
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김학기1, 조빈1, 정낙균1, 정대철1, 김소연1, 이현정1, 이경수1, 한경자2, 김원일2, 최일봉3, 김춘추4 |
1가톨릭대학교 의과대학 소아과학교실
2가톨릭대학교 의과대학 임상병리학교실
3가톨릭대학교 의과대학 치료방사선과학교실
4가톨릭대학교 의과대학 내과학교실 |
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| Abstract |
Purpose
: We reviewed 100 cases of HLA-matched sibling allogeneic bone marrow transplantation(
allo-BMT) in children and wish to share these results.
Methods
: One hundred children had undergone allo-BMT from HLA-identical siblings between Nov.
1983 and May 1998. There were 50 males and 50 females with a median age of 10 years and a
median follow-up of 38 months. Out of 100 cases, 43 children were transplanted for severe aplastic
anemia(SAA), 29 for acute myelogenous leukemia(AML), 18 for acute lymphocytic leukemia(ALL), 8
for chronic myelogenous leukemia(CML) and 2 for hemophagocytic lympho-histiocytosis(HLH).
Results
:SAA : The 5-year event free survival(EFS) of SAA was 91%. The types of events that occurred
were 3 thrombotic thrombocytopenic purpura(TTP), 2 venoocclusive disease(VOD) and 1
rejection. AML : In 25 of 29 cases, the 4-year EFS after allogeneic BMT in first remission was 71%.
That of the TBI-based and Busulfan-based group was 44% and 77%, respectively. The most
favorable results were observed in the Busulfan-based group in first remission with an EFS of
81%(n=18). The types of events that occurred were 4 TTP, 3 VOD, 2 rejections and 1 relapse. ALL :
Five-year EFS of children with complete remission(CR; n=14, 7 CR1, 7 CR2) was 81%. CML : For
the 6 children who received transplants while in the first chronic phase, the event free survival was
67%. HLH : Both of the two children with HLH survived 9 months and 24 months after BMT,
respectively. Acute GVHD(≥Grade Ⅱ) was observed in 13 children. Chronic GVHD developed in 10
children; 8 cases were localized and 2 were extensive type.
Conclusion
: Allo-BMT can cure children with refractory stem cell disorders. The most important
factor that influences survival after transplantation is interval between diagnosis and transplantation
for patients with severe aplastic anemia and remission state at transplantation for patients with leukemia. |
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