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Clinical outcomes of hematopoietic stem cell transplantation from HLA-matched parental donor in childhood acute leukemia

Korean Journal of Pediatrics 2008;51(1):67-72.
Published online January 15, 2008.
Clinical outcomes of hematopoietic stem cell transplantation from HLA-matched parental donor in childhood acute leukemia
Eun Young Cha1, Moon Hee Lee1, Jae Wook Lee1, Young Joo Kwon1, Dae Hyoung Lee2, Young-Shil Park3, Nak Gyun Chung1, Dae Chul Jeong1, Bin Cho1, Hack Ki Kim1
1Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
2Department of Pediatrics, College of Medicine, Hallym University, Seoul, Korea
3Department of Pediatrics, College of Medicine, Kyung Hee University, Seoul, Korea
소아 급성 백혈병 환자에서 주조직적합항원 일치 부모자식간조혈모세포 이식 후 임상경과
차은영1, 이문희1, 이재욱1, 권영주1, 이대형2, 박영실3, 정낙균1, 정대철1, 조빈1, 김학기1
1가톨릭대학교 의과대학 소아과학교실
2한림대학교 의과대학 소아과학교실
3경희대학교 의과대학 소아과학 교실
Correspondence: 
Bin Cho, Email: chobinkr@catholic.ac.kr
Abstract
Purpose
: In this study, we retrospectively analyzed the clinical outcomes of patients who underwent allogeneic hematopoietic stem cell transplantation (HSCT) grafted from HLA-matched parents.
Methods
: Seven children with acute leukemia (4 acute lymphoblastic leukemia, 3 acute myeloid leukemia) in first complete remission received allogeneic HSCT from their respective parents at the St. Marys Hospital between April, 1999 and October, 2005. The median age of patients at transplantation was 5 years (range, 1-11 years; 2 male, 5 female) and the median age of donors was 35 years (range, 30-41 years; 5 male, 2 female). We investigated the clinical outcomes such as engraftment, acute and chronic graft-versus-host disease (GVHD), transplant-related morbidity and mortality, relapse and survival.
Results
: Median time from transplantation to last follow-up was 69.5 months (range, 18.8-96.5 months). All patients were successfully engrafted, with a median time of 11 days (range, 10-16 days) and 26 days (range, 13-39 days) for neutrophil and platelet recovery, respectively. Grade II acute GVHD occurred in 3, and grade III acute GVHD in 1 of 7 recipients. Extensive chronic GVHD developed in 2, and limited chronic GVHD in 1 of 7 recipients. Death from transplant-related complications occurred in 1, and relapse occurred in 1 of 7 recipients. Estimated 5-year overall survival was 83?5%.
Conclusion
: The clinical outcomes of recipients who underwent HSCT from HLA-matched parents were comparable to those of patients who received HSCT grafted from HLA-matched sibling donors in childhood leukemia. HLA typing of parents, as well as siblings will increase the likelihood of finding an HLA-matched family donor for patients who need HSCT.
Key Words: Acute leukemia, Hematopoietic stem cell transplantation, HLA-matched parent


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