Allogeneic hematopoietic cell transplantation in patients with juvenile myelomonocytic leukemia in Korea: a report of the Korean Pediatric Hematology-Oncology Group

Eun Sang Yi, Seong Koo Kim, Hee Young Ju, Jae Wook Lee, Bin Cho, Bo Kyung Kim, Hyoung Jin Kang, Hee Jo Baek, Hoon Kook, Eu Jeen Yang, Young Tak Lim, Won Kee Ahn, Seung Min Hahn, Sang Kyu Park, Eun Sun Yoo, Keon Hee Yoo

Research output: Contribution to journalArticlepeer-review

Abstract

Juvenile myelomonocytic leukemia (JMML) is a life-threatening myeloproliferative neoplasm. This multicenter study evaluated the characteristics, outcomes, and prognostic factors of allogeneic hematopoietic cell transplantation (HCT) in recipients with JMML who were diagnosed between 2000 and 2019 in Korea. Sixty-eight patients were retrospectively enrolled—28 patients (41.2%) received HCT during 2000–2010 and 40 patients (58.8%) during 2011–2020. The proportion of familial mismatched donors increased from 3.6 to 37.5%. The most common conditioning therapy was changed from Busulfan/Cyclophosphamide-based to Busulfan/Fludarabine-based therapy. The 5-year probabilities of event-free survival (EFS) and overall survival (OS) were 52.6% and 62.3%, respectively. The 5-year incidence of transplant-related mortality was 30.1%. Multivariate analysis revealed that the proportion of hemoglobin F ≥ 40%, abnormal cytogenetics, and matched sibling donors were independent risk factors for a higher relapse rate. Patients whose donor chimerism was below 99% had a significantly higher relapse rate. Better OS and lower treatment-related mortality were observed in patients with chronic graft-versus-host disease (GVHD), whereas grade III or IV acute GVHD was associated with worse EFS. In conclusion, the number of transplant increased along with the increase in alternative donor transplants, nevertheless, similar results were maintained. Alternative donor transplantation should be encouraged.

Original languageEnglish
Pages (from-to)20-29
Number of pages10
JournalBone Marrow Transplantation
Volume58
Issue number1
DOIs
StatePublished - Jan 2023

Fingerprint

Dive into the research topics of 'Allogeneic hematopoietic cell transplantation in patients with juvenile myelomonocytic leukemia in Korea: a report of the Korean Pediatric Hematology-Oncology Group'. Together they form a unique fingerprint.

Cite this