Allogeneic transplantation of hematopoetic stem cells in acute leukemia in children, adolescents and young adults in the Republic of Belarus

Allogeneic hematopoietic stem cell transplantation (HSCT) is a recognized method for treating children with a very high risk group for acute lymphoblastic leukemia (ALL) and a high risk group for acute myeloid leukemia (AML). The use of allogeneic HSCT for certain risk groups of acute leukemia significantly improves the survival of these patients compared to chemotherapeutic regimens. The aim of this study was to identify the causes of failure of HSC transplantation in children with acute leukemia in a homogeneous group of patients and the possibility of further improvement in survival rates. The study was approved by the Independent Ethics Committee and the Scientific Council of the Belarusian Research Center for Pediatric Oncology, Hematology and Immunology (Republic of Belarus). The study included 101 patients with ALL and 65 patients with AML who underwent the first HSCT, in accordance with the first-line treatment protocol or relapse for 2 consecutive time periods (1998–2008 and 2009–2018). For the entire group of patients, an increase in overall (by 13%) and event-free survival (by 7%) was revealed due to a decrease in post-transplant mortality not related to relapse by 16% (p = 0.077). Significant improvement in survival over time occurred in the group of patients with acute or chronic “graft versus host” disease. The data obtained indicate that all patients with acute leukemia who have indications for HSCT in the first line of treatment or relapse should be transplanted from any available donor, as this will significantly increase their chances of recovery.