Allogeneic bone marrow transplantation for infants with acute leukemia or myelodysplastic syndrome

The objective of this study is to investigate the outcome of children 24 mo nths of age or younger (infants) at the time of allogeneic bone marrow tran splantation (BMT) for acute leukemia or myelodysplasia, We analyzed the sur vival rate, prognostic factors, incidences of late sequelae, and immune rec onstitution in 22 infants who underwent allogeneic BMT. The 5-year event-fr ee survival estimate was 45.5% (95% confidence interval(CI), 24.4% to 63.3% ). Six patients died of transplant-related complications and six died of di sease relapse. Remission status at the time of BR;IT was the most important prognostic factor (P = 0.005): no patient who received a transplant while their disease was not in remission survived, whereas the 5-year survival es timate for infants who underwent BMT during remission was 56% (95% CI, 31% to 75%). Long-term outcomes in the 10 infant survivors were compared with t hose of 10 older controls matched for diagnosis, disease status at the time of BR;IT, calendar year at the time of BR IT, and source of stem cells. Im mune function 1 year after transplantation and the incidences and spectra o f late sequelae were similar for both groups during a median of 3.5 gears ( range, 1.5 to 7.2 years) of follow-up.