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Adolescent and young adult (AYA) patients with acute leukemia (AL) have inferior outcomes in comparison to younger patients, and are more likely to develop acute and chronic GVHD than younger children following HLA matched sibling donor stem cell transplant (SCT). We compared the incidence of grade II-IV acute GVHD, chronic GVHD, and survival in AYA (age 13-21 years) to younger children (age 2-12 years) who received an unrelated donor SCT for acute leukemia on Children's Oncology Group trials between 2004-2017. One hundred and eighty-eight children and young adults ages 2-21 years underwent URD SCT. Sixty-three percent were aged 2-12 and 37% were age 13-21. Older age was a risk factor for grade II-IV acute GVHD in multivariate analysis with a hazard ratio (HR) of 1.95 [95% confidence interval (CI) 1.23-3.10], but not for chronic GVHD, HR 1.25 [95% CI 0.57-2.71]. Younger patients relapsed more often (34.5 ± 4.4% vs. 22.8 ± 4.0%, p = 0.032), but their Event-Free Survival (42.6 ± 4.7% vs. 51.8 ± 6.1%, p = 0.18) and Overall Survival at 5 years (48.5 ± 4.9% vs. 51.5 ± 6.4%, p = 0.56) were not different than AYA patients. AYA patients who receive an URD SCT for acute leukemia are significantly more likely to develop grade II-IV acute GVHD, though survival is similar.

Titel:	Adolescent and young adult (AYA) versus pediatric patients with acute leukemia have a significantly increased risk of acute GVHD following unrelated donor (URD) stem cell transplantation (SCT): the Children's Oncology Group experience.
Autor/in / Beteiligte Person:	Andolina, JR ; Wang, YC ; Ji, L ; Freyer, DR ; Levine, JE ; Pulsipher, MA ; Gamis, AS ; Aplenc, R ; Roth, ME ; Harrison, L ; Cairo, MS
Link:	View record at Springer (Volltext)
Zeitschrift:	Bone marrow transplantation, Jg. 57 (2022-03-01), Heft 3, S. 445-452
Veröffentlichung:	<2003->: London : Nature Publishing Group ; <i>Original Publication</i>: Basingstoke, Hampshire : Scientific & Medical Division, Macmillan Press, c1986-, 2022
Medientyp:	academicJournal
ISSN:	1476-5365 (electronic)
DOI:	10.1038/s41409-021-01558-6
Schlagwort:	Acute Disease Adolescent Child Humans Retrospective Studies Stem Cell Transplantation adverse effects Unrelated Donors Young Adult Graft vs Host Disease etiology Hematopoietic Stem Cell Transplantation adverse effects Leukemia, Myeloid, Acute
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't Language: English [Bone Marrow Transplant] 2022 Mar; Vol. 57 (3), pp. 445-452. <i>Date of Electronic Publication: </i>2022 Jan 06. MeSH Terms: Graft vs Host Disease* / etiology ; Hematopoietic Stem Cell Transplantation* / adverse effects ; Leukemia, Myeloid, Acute* ; Acute Disease ; Adolescent ; Child ; Humans ; Retrospective Studies ; Stem Cell Transplantation / adverse effects ; Unrelated Donors ; Young Adult References: Bleyer A, Barr R, Hayes-Lattin B, Thomas D, Ellis C, Anderson B. The distinctive biology of cancer in adolescents and young adults. Nat Rev Cancer. 2008;8:288–98. https://doi.org/10.1038/nrc2349 . e-pub ahead of print 2008/03/21. (PMID: 10.1038/nrc234918354417) ; McNeer JL, Bleyer A. Acute lymphoblastic leukemia and lymphoblastic lymphoma in adolescents and young adults. 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Adolescent and young adult (AYA) versus pediatric patients with acute leukemia have a significantly increased risk of acute GVHD following unrelated donor (URD) stem cell transplantation (SCT): the Children's Oncology Group experience.