Αρχέγονα αιμοποιητικά κύτταρα: καθοριστικά στη θεραπεία παιδικών λευχαιμιών

Abstract

INTRODUCTION: Previous studies have reached contradictory results regarding the outcomes of stem cells transplantation in children under 18 years of age suffering from leukemia. PURPOSE: The present literature review has evaluated studies that examined the type of the stem cells graft on the outcome of transplantation, regarding mortality, survival, relapse and incidence of GVHD. MATERIAL-METHOD: A composite search was performed in the PubMed, using keywords: «allogeneic» vs «autologous transplantation» OR «autografts» vs «allografts» OR «related» vs «unrelated donor» AND «leukemia» AND «children» OR «pediatric». RESULTS: In studies comparing allogeneic-autologous transplantation, two of them agree on higher rates of mortality in children with autologous grafts by comparison to those with allogeneic grafts, while in the third one, only children who received allogeneic grafts died. There is agreement on the fact that relapse was higher in auto-transplanted children. All studies reported incidence of acute or chronic GVHD only in allogeneic group. There was disagreement regarding survival, where one of the studies, reported higher rates in allogeneic group, the other, higher rates in autologous group and the trird equal results in both groups. Most of the studies comparing relative and non-relative donor, a higher relapse and longer survival in patients with relative donor were observed. Regarding mortality, patients without a relative donor had higher rates, but with regards to GVHD 2 to 3 studies showed higher rates among patients with non-relative donor. CONCLUSION: The rates of relapse were higher in children that received autologous grafts in comparison with those receiving allogeneic. Acute or chronic GVHD reported only in allogeneic group. Regarding children with non-relative donor, the mortality was higher.