SANTANDER, SpainHigh-dose chemotherapy (HDC) with stem cell
transplantation offers a striking improvement over
conventional chemotherapy for infants with acute leukemia, said
Fernando Marco, MD, a hematologist at Hospital Universitario Marques
de Valdecilla, Santander, Spain.
In this study, 26 infants with acute leukemia underwent high-dose
chemotherapy with stem cell transplantation (eight allogeneic and 18
autologous). Fifteen patients had acute myeloid leukemia, 10 had
acute lymphoid leukemia, and one had a bilineal leukemia.
All patients had been previously treated: 22 were in their first
complete remission, three were in their second complete remission,
and one was in relapse.
At 67 months median follow-up, the 5-year overall survival rate is
64% and the 5-year disease-free survival rate is 63%. Outcomes were
similar with use of allogeneic and autologous transplantation (J
Clin Oncol 18:3256-3261, 2000).
No Transplant-Related Deaths
Dr. Marco reported that there was no transplant-related mortality;
all deaths were due to relapse in the first 6 months after
transplantation. In multivariate analysis, he said, the single factor
associated with better disease-free survival was an interval between
first complete remission and transplantation of less than 4 months (P
Stem cell transplantation is a valid option in the treatment of
infant acute leukemia, Dr. Marco concluded, and it may
overcome the high risk of relapse with conventional chemotherapy. The
study suggests that stem cell transplantation should be performed
when the patient is in first complete remission.