Improvement of overall survival after allogeneic hematopoietic stem cell transplantation for children and adolescents: a three-decade experience of a single institution
Autor: | N Corradini, E Thebaud, Patrice Chevallier, Philippe Moreau, Rialland X, Francoise Mechinaud, N. Blin, Caroline Thomas, Xavier Cahu, Eolia Brissot, Noel-Jean Milpied, M. Strullu, Mohamad Mohty, J L Harousseau, Fanny Rialland |
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Přispěvatelé: | Centre hospitalier universitaire de Nantes (CHU Nantes), Centre d'investigation clinique en cancérologie (CI2C), CHU Pontchaillou [Rennes] |
Rok vydání: | 2015 |
Předmět: |
Adult
medicine.medical_specialty Adolescent [SDV]Life Sciences [q-bio] medicine.medical_treatment Hematopoietic stem cell transplantation Single Center Disease-Free Survival 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Cumulative incidence Child Survival rate Retrospective Studies Transplantation business.industry Hematopoietic Stem Cell Transplantation Infant Retrospective cohort study Hematology Allografts medicine.disease Surgery Survival Rate Graft-versus-host disease Child Preschool Hematologic Neoplasms 030220 oncology & carcinogenesis Stem cell business Follow-Up Studies 030215 immunology |
Zdroj: | Bone Marrow Transplantation Bone Marrow Transplantation, Nature Publishing Group, 2016, 51 (2), pp.267--272. ⟨10.1038/bmt.2015.250⟩ |
ISSN: | 1476-5365 0268-3369 |
DOI: | 10.1038/bmt.2015.250 |
Popis: | International audience; Allogeneic stem cell transplantation (allo-SCT) has become an essential component of the treatment for a variety of diseases in pediatric patients. During the past decades, advances in the transplant technology, availability of hematopoietic stem cells and supportive care not only have resulted in improved outcomes, but also have expanded the transplant options. However, these features have been studied mainly in adult populations. This investigation analyzed changes in patient profile, transplantation, graft characteristics and outcome among 250 children and adolescent patients who received allo-SCT in a single center between 1983 and 2010. In the 2000–2010, compared with the 1983–1999 period, a significantly higher 5-year overall survival (64% versus 52%, P=0.03) was observed together with a significant decrease of non-relapse mortality (27% versus 9%, P=0.0002). The progression-free survival was comparable between the two periods (49% versus 57%; P=0.17). The 5-year cumulative incidence of relapse was 24% between 1983 and 1999, and 34% between 2000 and 2010 (P=0.08). Major advances in supportive care practice have been made over the past decade, resulting in a significant survival benefit for the pediatric population undergoing allo-SCT. However, post-transplant relapse remains the leading cause of failure of this therapeutic approach, and preventing relapse represents a major challenge today |
Databáze: | OpenAIRE |
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