PMID- 16679917
OWN - NLM
STAT- MEDLINE
DCOM- 20060613
LR  - 20111006
IS  - 1077-4114 (Print)
IS  - 1077-4114 (Linking)
VI  - 28
IP  - 4
DP  - 2006 Apr
TI  - Hematopoietic stem cell transplantation after first marrow relapse of non-T, 
      non-B acute lymphoblastic leukemia: a pediatric oncology group pilot feasibility 
      study.
PG  - 210-5
AB  - BACKGROUND: Relapsed acute lymphoblastic leukemia (ALL) in children is associated 
      with a poor outcome, especially for those patients whose relapse occurs during 
      the first 36 months after diagnosis. The best therapy for these patients is not 
      known. This study was designed to evaluate the feasibility of enrolling children 
      with recurrent ALL in a standardized treatment protocol that included receipt of 
      a hematopoietic stem cell transplant (HSCT). PROCEDURE: Eligible patients with a 
      bone marrow relapse of non-T, non-B ALL underwent a common induction and 
      consolidation followed by receipt of either an allogeneic HSCT from a human 
      leukocyte antigen (HLA)-identical sibling or an autologous HSCT purged with B-4 
      blocked ricin. A common conditioning regimen was used for all patients. RESULTS: 
      Twenty-eight patients from eight institutions were enrolled. Fourteen patients 
      did not receive a transplant during the study, because of toxicity (4), relapse 
      (1), inadequate purging (1), and parental or physician preference for an 
      alternative donor transplant (8). Six patients received allogeneic HSCTs. Five of 
      them have remained in remission for a median of 78 months. Eight patients 
      received autologous HSCTs purged with B4-blocked ricin. Four have remained in 
      remission for a median of 94 months. Of the nine patients who received 
      alternative donor transplants, only two remain in remission. CONCLUSION: We 
      conclude that well designed and controlled prospective studies are necessary to 
      define the role of HSCTs in children with recurrent ALL. In order to be 
      successful, such studies must have the full support of participating centers. 
      Autologous HSC transplantation may have a role in the treatment of relapsed ALL, 
      but further studies are needed.
FAU - Sandler, Eric S
AU  - Sandler ES
AD  - Department of Hematology/Oncology, Nemours Children's Clinic, 807 Children's Way, 
      Jacksonville, FL 32207, USA. esandler@nemours.org
FAU - Homans, Alan
AU  - Homans A
FAU - Mandell, Lynda
AU  - Mandell L
FAU - Amylon, Michael
AU  - Amylon M
FAU - Wall, Donna A
AU  - Wall DA
FAU - Devidas, Meenakshi
AU  - Devidas M
FAU - Buchanan, George R
AU  - Buchanan GR
FAU - Lipton, Jeffrey M
AU  - Lipton JM
FAU - Billett, Amy L
AU  - Billett AL
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Multicenter Study
PL  - United States
TA  - J Pediatr Hematol Oncol
JT  - Journal of pediatric hematology/oncology
JID - 9505928
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Antineoplastic Combined Chemotherapy Protocols
MH  - Bone Marrow/*pathology
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Humans
MH  - Male
MH  - Pilot Projects
MH  - Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy/pathology/*therapy
MH  - Recurrence
MH  - *Stem Cell Transplantation
MH  - Treatment Outcome
EDAT- 2006/05/09 09:00
MHDA- 2006/06/14 09:00
CRDT- 2006/05/09 09:00
PHST- 2006/05/09 09:00 [pubmed]
PHST- 2006/06/14 09:00 [medline]
PHST- 2006/05/09 09:00 [entrez]
AID - 00043426-200604000-00004 [pii]
AID - 10.1097/01.mph.0000212902.84146.81 [doi]
PST - ppublish
SO  - J Pediatr Hematol Oncol. 2006 Apr;28(4):210-5. doi: 
      10.1097/01.mph.0000212902.84146.81.