G-CSF combination myeloablative conditioning regimen for pediatric acute myeloid leukemia

Abstract

We retrospectively analyzed the clinical outcome of 12 pediatric patients with acute myeloid leukemia (AML) undergoing allogeneic hematopoietic stem cell transplantation (HSCT) using a myeloablative conditioning regimen consisting of granulocyte colony-stimulating factor (G-CSF), cytarabine, cyclophosphamide, and total-body irradiation in our hospital between 1995 and 2014. Eleven patients were in complete remission (CR; 6 in CR1, 5 in CR2) and one patient was not in remission. Both the 5-year overall survival and disease-free survival rates in patients undergoing HSCT in CR were 62.3±15.0% and 63.6±14.5%, respectively. One patient experienced primary engraftment failure, and two patients experienced post-HSCT relapse. Grades II–IV acute and chronic GVHD were observed in 7/11 and 2/9 patients, respectively. Five patients died due to bacterial infection (n=1), disease progression (n=1), and complications after the second HSCT (n=3). In this study, no marked beneficial effect of the regimen was observed in pediatric patients, unlike in adult patients with AML. Considering the high incidence of late adverse effects, reduced-toxicity regimens, such as G-CSF-combined reduced-intensity conditioning regimen, would be feasible for pediatric patients with AML.