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Allogeneic hematopoietic stem cell transplantation for 27 children with juvenile myelomonocytic leukemia diagnosed based on the criteria of the International JMML Working Group

Leukemia volume 16, pages 645–649 (2002)Cite this article

Abstract

Prognostic factors of juvenile myelomonocytic leukemia (JMML) have not been clarified because of its very low incidence and inaccuracy in the diagnosis. The purpose of this study was to evaluate children with JMML given an allogeneic hematopoietic stem cell transplantation (SCT) and the role of different variables potentially influencing outcome in a nationwide survey in Japan based on the newly proposed criteria by the International JMML Working Group. The study patients were 27 children who underwent SCT among 55 JMML patients retrospectively collected in the survey. The source of grafts was HLA-identical siblings in 12 cases, HLA-matched unrelated individuals in 10 and others in five. Total body irradiation was used in 18 cases. Event-free and overall survival (OS) at 4 years after SCT were 54.2 ± 11.2% (s.e.) and 57.9 ± 11.0% (s.e.), respectively. Six patients died of relapse and three of complications. Patients with abnormal karyotypes showed a significantly lower OS than those with normal karyotypes (P < 0.001). Patients below 1 year of age showed a significantly higher OS than those of 1 year of age or more (P = 0.02). Patients with grade 0–1 acute graft-versus-host disease (GVHD) or chronic GVHD had a more favorable OS than those without them, although they were not statistically significant (P > 0.05). Other variables studied were not associated with OS. A multivariate analysis of these factors yielded the abnormal karyotype as the only significant risk factor for lower OS (risk ratio: 11.0; 95% CI: 2.7–45.1).

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Acknowledgements

We thank Drs T Ichihara, Y Gunji, K Kawakami, K Tsunamoto, K Sano, H Kigasawa, M Yabe, S Tsuchiya, H Mugishima, Y Ishikawa, and K Horibe for providing the data of patients. We also thank all the members of the Japanese Society of Pediatric Hematology and D Mrozek for his editorial assistance.

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Authors and Affiliations

  1. Institute of Medical Science, University of Tokyo, Tokyo, Japan

    A Manabe

  2. Institute for Clinical Research, National Kyushu Cancer Center, Fukuoka, Japan

    J Okamura

  3. Department of Pediatrics, Osaka Medical Center, Osaka, Japan

    K Yumura-Yagi

  4. Department of Pediatrics, National Kyoto Hospital, Kyoto, Japan

    Y Akiyama

  5. Division of Pediatrics, Osaka City General Hospital, Osaka, Japan

    M Sako

  6. Department of Pediatrics, Jikei University, Tokyo, Japan

    H Uchiyama

  7. Department of Pediatrics, Nagoya University, Nagoya, Japan

    S Kojima

  8. Department of Pediatrics, University of Shinshu, Matsumoto, Japan

    K Koike

  9. Division of Environmental Epidemiology, National Children's Hospital, Tokyo, Japan

    T Saito

  10. Department of Pediatrics, Kyoto University, Kyoto, Japan

    T Nakahata

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  1. A Manabe
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for the MDS Committee of the Japanese Society of Pediatric Hematology

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Manabe, A., Okamura, J., Yumura-Yagi, K. et al. Allogeneic hematopoietic stem cell transplantation for 27 children with juvenile myelomonocytic leukemia diagnosed based on the criteria of the International JMML Working Group. Leukemia 16, 645–649 (2002). https://doi.org/10.1038/sj.leu.2402407

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