ASBMT Position Statement Explains
Role of Stem Cell Transplants
in Children with Leukemia
For many children with acute myeloid leukemia (AML), transplantation of blood or marrow stem cells, combined with chemotherapy, offers improved survival compared to chemotherapy alone. Allogeneic transplantation using blood or marrow stem cells from donors related to the patient offers better survival than autologous transplants.
These are among the guidelines included in an ASBMT position statement on stem cell therapy for pediatric AML, published in the April 2007 issue of Biology of Blood and Marrow Transplantation.
The recommendations are based on an evidence-based review of the scientific literature on the use of hematopoietic stem cell transplantation (HSCT) in children with AML. Developed in collaboration with the National Marrow Donor Program (NMDP), the review was conducted by a panel of independent experts in transplantation and other treatments for leukemia.
For patients with certain forms of cancer, such as leukemia, and specific genetic diseases or blood disorders, HSCT can improve survival and, in many cases, cure the disease, according to the evidence-based review and the position statement. Among the specific recommendations are:
§ Allogeneic HSCT after chemotherapy offers superior overall survival and leukemia-free survival when compared to chemotherapy alone for patients in first complete remission.
§ Autologous HSCT or chemotherapy alone given in the first complete disease remission are equivalent in outcomes, but a lack of data on quality of life, secondary cancers and other late effects of treatment prevent a recommendation of one treatment over another.
§ HSCT is recommended over chemotherapy alone in second complete remission when a suitably matched related donor is available.
§ Hematopoietic stem cells donated by a matched related or unrelated donor are superior in outcome to stem cells harvested through autologous transplantation in first and second complete remission.
Posted on the ASBMT Web site are:
§ The Position Statement on Pediatric AML.
§ The Evidence-Based Review on Pediatric AML.
§ Previously published evidence-based reviews on the use of hematopoietic stem cell transplant in treating non-Hodgkin’s lymphoma, multiple myeloma and acute lymphoblastic leukemia in children and adults.