부산대학교 도서관

This single-center retrospective study reported the outcome of 19 children treated with a reduced-intensity conditioning (RIC) regimen prior to allogeneic stem cell transplantation (allo-SCT), for hematologic malignancies ( n = 17), bone marrow failure ( n = 1), and neuroblastoma ( n = 1). Children were ineligible for standard myeloablative conditioning because of severe comorbidities ( n = 9), a previous auto or allo-SCT ( n = 7) or a prior history of extensive chemotherapy ( n = 3). All patients underwent a fludarabine-based RIC regimen, and received grafts from matched-related donors ( n = 5), match-unrelated donors ( n = 6), or unrelated cord blood (UCB, n = 8). In this series, two patients treated with UCB failed to engraft and 63% achieved full donor chimerism at day 100 after allo-SCT. With a median follow-up of 537 d (range, 115-4136), treatment-related mortality was 16% and overall survival was 47%. The principal cause of death was disease relapse ( n = 7). Acute graft versus host disease (GVHD) occurred in 53% of patients, while only 10% developed extensive chronic GVHD. Overall, results from this series suggest that RIC allo-SCT can be a valid alternative treatment option in unfit children with malignant hematological diseases. Prospective studies are needed to enlarge pediatric experience in this domain and better identify those children more suitable for a RIC allo-SCT approach. [ABSTRACT FROM AUTHOR]