Evaluating the benefits of allogeneic hematopoietic stem cell transplantation in childhood acute myeloid leukemia.

This study analyzed the use of allogeneic hematopoietic stem cell transplantation (alloHSCT) therapy following first remission in children with newly diagnosed, high-risk acute myeloid leukemia (AML) compared to chemotherapy. This study supports the use of alloHSCT for children with AML that are at greater.

Childhood AML is a type of cancer affecting the blood and bone marrow. Advances in therapeutic approaches have led to more children achieving first complete remission (CR1). CR occurs when bone marrow and blood cell counts have returned to normal levels. However, relapse (recurrence after a period of improvement) remains high in these patients.

AlloHSCT is a therapy used in adults following remission that improves survival in patients with intermediate and poor-risk AML compared to chemotherapy alone. AlloHSCT involves the transplantation of stem cells from a healthy donor to the patient. The benefit of alloHSCT in childhood AML remains unclear mainly due to a lack of randomized clinical trials. There is a need to evaluate the results of currently available studies to provide some understanding of the benefit of alloHSCT in high-risk childhood AML.

This analysis evaluated the results of 9 studies that included 1448 patients with high-risk childhood AML. The studies compared alloHSCT therapy in CR1 to chemotherapy alone as post-remission therapy. 522 patients were treated with alloHSCT while 926 patients had chemotherapy.

Patients given alloHSCT showed a 15% improvement in overall survival (OS) compared to those that had chemotherapy alone. Patients treated with alloHSCT had a 31% improvement in survival without signs of AML compared to patients that received chemotherapy alone.

Patients that received chemotherapy had a 26% higher rate of relapse compared to those given alloHSCT.

The study concluded that alloHSCT improved the outcomes of children with high-risk AML compared to chemotherapy alone.

This analysis included a small number of studies. The studies used different chemotherapy protocols and alloHSCT strategies. Further studies using randomized controlled trials are needed.