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Br J Haematol. 2008 Jan;140(1):86-9. Epub 2007 Sep 25.

Outcome of haematopoietic stem cell transplantation for paediatric acute lymphoblastic leukaemia in third complete remission: a vital role for graft-versus-host-disease/ graft-versus-leukaemia effect in survival.

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Division of Haematology/Oncology/BMT, Hospital for Sick Children, University of Toronto, Ontario, Canada.


Children with acute lymphoblastic leukaemia (ALL) receiving haematopoietic stem cell transplantation (HSCT) in third complete remission (CR3) are at high risk for transplant-related mortality (TRM) and relapse. Twenty-two consecutive children with ALL in CR3 received HSCT between January 1994 and August 2005. Ten patients died of TRM, seven patients relapsed, six did not have graft-versus-host disease (GVHD). Five patients were long-term survivors, (median follow-up, 5.8 years; range 2.9-11.7). Three-year event-free survival was 0.32 (95% confidence interval 0.19 and 0.59). Survivors had moderate to severe GVHD. Allowing some GVHD or exploring means of inducing GVHD should be considered in CR3 patients.

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