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Outcome of haematopoietic stem cell transplantation for paediatric acute lymphoblastic leukaemia in third complete remission: a vital role for graft-versus-host-disease/ graft-versus-leukaemia effect in survival

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Children with acute lymphoblastic leukaemia (ALL) receiving haematopoietic stem cell transplantation (HSCT) in third complete remission (CR3) are at high risk for transplant-related mortality (TRM) and relapse. Twenty-two consecutive children with ALL in CR3 received HSCT between January 1994 and August 2005. Ten patients died of TRM, seven patients relapsed, six did not have graft-versus-host disease (GVHD). Five patients were long-term survivors, (median follow-up, 5·8 years; range 2·9–11·7). Three-year event-free survival was 0·32 (95% confidence interval 0·19 and 0·59). Survivors had moderate to severe GVHD. Allowing some GVHD or exploring means of inducing GVHD should be considered in CR3 patients.
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Keywords: acute lymphoblastic leukaemia; graft-versus-host disease; graft-versus-leukaemia-effect; haematopoietic stem cell transplantation; third complete remission

Document Type: Research Article

Affiliations: 1: Division of Haematology/Oncology/BMT 2: Division of Clinical Research Support Unit, Hospital for Sick Children, University of Toronto, Ontario, Canada

Publication date: 01 January 2008

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