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A review on allogeneic stem cell transplantation for newly diagnosed pediatric acute myeloid leukemia Niewerth D; Creutzig U; Bierings MB; Kaspers GJBlood 2010[Sep]; 116 (13): 2205-14Survival of pediatric acute myeloid leukemia (AML) has improved considerably over the past decades. Since 1985, allogeneic stem cell transplantation (allo-SCT) is widely recommended for patients who have a matched sibling donor. However, it remains controversial whether allo-SCT is superior to chemotherapy for children with newly diagnosed AML. This review summarizes phase 3 clinical trials that compared allo-SCT with chemotherapy (including autologous SCT) in pediatric AML, excluding studies that did not use the intention-to-treat analysis or correct for time-to-transplantation. Although allo-SCT might prevent more relapses than chemotherapy, the number needed for transplantation (with allo-SCT) to prevent one relapse is in the order of 10 patients. Moreover, overall survival is similar with both methods in most recent studies, apparently because of increased salvagability of a relapse when initial therapy concerned chemotherapy only, and because of a higher treatment-related mortality with allo-SCT. Because allo-SCT also gives more severe side effects and results more often in secondary malignancies than chemotherapy, we do not recommend allo-SCT in first remission for pediatric AML in general. Further research should focus on the possibility that subgroups might benefit from allo-SCT, aiming at further improvements in the prognosis of pediatric AML.|*Stem Cell Transplantation/adverse effects/economics[MESH]|Antineoplastic Combined Chemotherapy Protocols/therapeutic use[MESH]|Child[MESH]|Clinical Trials, Phase III as Topic[MESH]|Cost-Benefit Analysis[MESH]|Disease-Free Survival[MESH]|Humans[MESH]|Leukemia, Myeloid, Acute/drug therapy/*therapy[MESH]|Remission Induction[MESH]|Survival Analysis[MESH]|Transplantation, Autologous[MESH]|Transplantation, Homologous[MESH]|Treatment Outcome[MESH] |
