Unrelated donor bone marrow transplantation for 100 pediatric patients: a single institute's experience: Allografting

In all, 100 unrelated donor bone marrow transplantations (UD-BMT) were performed in our institute between October 1993 and January 2003. Of 93 evaluable patients, 73 patients had hematological malignancy, 13 had nonmalignancy and seven had lymphoproliferative disease. The estimated 9-year event-free survival (EFS) rate was 57.1±5.5% in all patients. In the following analyses of the patients with hematological malignancy, the standard group had significantly better EFS than the high-risk group (61.5±7.0 vs 35.6±9.7%, P =0.02), and the EFS rate of the tacrolimus (FK-506)+methotrexate (MTX)±methylprednisolone prophylactic group for graft-versus-host disease was superior to that of the FK-506 without MTX group (75.7±8.0 vs 55.8±7.6%, P =0.02). When we compared the EFS rates of the FK506+MTX±methylprednisolone (mPSL) group and the HLA-matched related donor BMT group in our institute, these were almost similar (75.7±8.1 vs 68.4±9.3%). Therefore, UD-BMT using FK-506+MTX±mPSL is a safe and useful method for children with hematological malignancy who require allogeneic BMT.