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Total body irradiation plus fludarabine versus thiotepa, busulfan plus fludarabine as a myeloablative conditioning for adults with acute lymphoblastic leukemia treated with haploidentical hematopoietic cell transplantation. A study by the Acute Leukemia Working Party of the EBMT
R. Swoboda, M. Labopin, S. Giebel, E. Angelucci, M. Arat, M. Aljurf, S. Sica, J. Pavlu, G. Socié, P. Bernasconi, L. Rigacci, J. Tischer, A. Risitano, M. Rovira, R. Saccardi, P. Pioltelli, G. Van Gorkom, A. Vitek, BN. Savani, A. Spyridonidis, Z....
Language English Country Great Britain
Document type Journal Article
NLK
Free Medical Journals
from 1997 to 1 year ago
Freely Accessible Science Journals
from 1997 to 1 year ago
ProQuest Central
from 2000-01-01 to 1 year ago
Open Access Digital Library
from 1997-01-01
Health & Medicine (ProQuest)
from 2000-01-01 to 1 year ago
- MeSH
- Precursor Cell Lymphoblastic Leukemia-Lymphoma * complications therapy MeSH
- Leukemia, Myeloid, Acute * therapy MeSH
- Busulfan adverse effects MeSH
- Whole-Body Irradiation adverse effects MeSH
- Adult MeSH
- Humans MeSH
- Graft vs Host Disease * etiology MeSH
- Transplantation Conditioning methods MeSH
- Recurrence MeSH
- Retrospective Studies MeSH
- Thiotepa adverse effects MeSH
- Hematopoietic Stem Cell Transplantation * adverse effects MeSH
- Vidarabine analogs & derivatives MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Publication type
- Journal Article MeSH
Optimal conditioning for adults with acute lymphoblastic leukemia (ALL) treated with haploidentical hematopoietic cell transplantation (haplo-HCT) and post-transplant cyclophosphamide has not been established so far. We retrospectively compared outcomes for two myeloablative regimens: fludarabine + total body irradiation (Flu-TBI, n = 117) and thiotepa + iv. busulfan + fludarabine (TBF, n = 119). Patients transplanted either in complete remission (CR) or with active disease were included in the analysis. The characteristics of both groups were comparable except for patients treated with TBF were older. In univariate analysis the incidence of non-relapse mortality (NRM) at 2 years was increased for TBF compared to Flu-TBI (31% vs. 19.5%, p = 0.03). There was a tendency towards reduced incidence of relapse after TBF (p = 0.11). Results of multivariate analysis confirmed a reduced risk of NRM using Flu-TBI (HR = 0.49, p = 0.03). In the analysis restricted to patients treated in CR1 or CR2, the use of Flu-TBI was associated with a decreased risk of NRM (HR = 0.34, p = 0.009) but an increased risk of relapse (HR = 2.59, p = 0.01) without significant effect on survival and graft-versus-host disease. We conclude that for haplo-HCT recipients with ALL, Flu-TBI may be preferable for individuals at high risk of NRM while TBF should be considered in cases at high risk of relapse.
Azienda Ospedaliera Universitaria Careggi Cell Therapy and Transfusion Medicine Unit Firenze Italy
BMT unit Clinica Ematologica Fondazione IRCCS Policlinico San Matteo Pavia Italy
BMT Unit University Hospital of Patras Patras Greece
Centre for Haematology Imperial College London Hammersmith Hospital London United Kingdom
Department of Haematology Saint Antoine Hospital
Department of Hematology Oncology Vanderbilt University Medical Center Nashville USA
Department of Internal Medicine University of Zagreb School of Medicine Zagreb Croatia
Hematology and Transplant Center IRCCS Ospedale Policlinico San Martino Genova Italy
Hôpital Saint Antoine Paris France
Hopital St Louis Dept of Hematology BMT Paris France
Hospital Clinic Institute of Hematology and Oncology Dept of Hematology Barcelona Spain
INSERM UMR 938 Sorbonne University Paris France
Institute of Hematology and Blood Transfusion Servicio de Hematología Prague Czech Republic
King Faisal Specialist Hospital and Research Centre Oncology Riyadh Saudi Arabia
Klinikum Grosshadern Med Klinik 3 Munich Germany
Nightingale Sisli Hospital Hematopoietic SCT Unit Istanbul Turkey
Ospedale S Camillo Forlanini Dept of Hematology and BMT Rome Italy
Ospedale San Gerardo Clinica Ematologica dell'Universita Milano Biocca Monza Italy
Universita Cattolica S Cuore Istituto di Ematologia Ematologia Rome Italy
University Hospital Maastricht Dept Internal Med Hematology Oncology Maastricht The Netherlands
University of Napoli 'Federico II' Medical School Division of Hematology Napoli Italy
References provided by Crossref.org
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