Mobilization of PML-RARA negative blood stem cells and salvage with autologous peripheral blood stem cell transplantation in children with relapsed acute promyelocytic leukemia

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BackgroundRelapsed acute promyleocytic leukemia (APL) is treated with re-induction chemotherapy, commonly arsenic trioxide, and stem cell transplantation (SCT). The effect of arsenic trioxide on autologous peripheral blood stem cell collection is unknown.ProcedureFive pediatric patients with relapsed APL had PML-RARA negative peripheral blood stem cells mobilized (four after arsenic trioxide) and underwent autologous SCT after cyclophosphamide (60 mg/kg × 2) and total body irradiation (TBI-fractionated 1,200 cGy) conditioning.ResultsAll five patients remain in molecular remission a median of 20 months post-transplant.ConclusionAutologous SCT performed during molecular remission is a treatment option for pediatric patients with relapsed APL and may provide durable leukemia-free survival without the complications of allogeneic transplantation. Pediatr Blood Cancer 2008;51:521–524. © 2008 Wiley-Liss, Inc.

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