Conditioning regimens for acute lymphoblastic leukaemia allografts

Marks, David I.

doi:10.1038/sj.bmt.1705595

Cited by 2 publications

(2 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Based on comparative retrospective studies in adults, and prospective, randomized studies in children, however, TBI, and not BU, has become the standard for AHCT for patients with ALL. 11,12 Our singleinstitution study, adjusted for age and other known prognostic factors, could not confirm a significant benefit of TBI in EFS or OS compared with BU. However, TBI did reduce the incidence of extramedullary relapse.…”

Section: Discussionmentioning

confidence: 79%

BU- vs TBI-based conditioning for adult patients with ALL

Kalaycio

Bolwell

Rybicki

et al. 2010

Bone Marrow Transplant

View full text Add to dashboard Cite

Evidence suggests an advantage for TBI over BU as a component of conditioning regimens for allogeneic hematopoietic cell transplant in patients with ALL. We have employed both TBI and BU for conditioning in ALL and reviewed our experience to compare outcomes. From July 1989 to June 2008, we identified 86-adult ALL patients treated with either a TBI-or BU-based regimen and transplanted with either a well-matched sibling or unrelated donor. Data including demographics, immunophenotype, disease status and cytogenetic risk were examined by Cox proportional hazards analysis. Patients treated with TBI were older (median age 40 vs 33 years; P ¼ 0.018), had a higher-risk cytogenetic profile (P ¼ 0.010), were more often transplanted using an unrelated donor (P ¼ 0.038) and were treated more recently (Po0.001). There was a significant improvement in EFS (P ¼ 0.046), and a trend to improved OS (P ¼ 0.08) in patients treated with TBI compared with those treated with BU. However, the advantage for TBI could not be confirmed by multivariable analysis where only disease status retained statistical significance.

show abstract

Section: Discussionmentioning

confidence: 79%

BU- vs TBI-based conditioning for adult patients with ALL

Kalaycio

Bolwell

Rybicki

et al. 2010

Bone Marrow Transplant

View full text Add to dashboard Cite

show abstract

“…43,44 Among the patients with high-risk ALL in first complete remission, a comparison of various conditioning regimens, all including total body irradiation combined with different cytotoxic drugs, did not show any significant differences in transplant-related mortality, relapse incidence and disease-free survival. In our cohort of patients, we did not observe any differences in diseasefree survival, relapse incidence or early transplant-related mortality between patients given either total body irradiation or chemotherapy-based regimens (90% versus 10% of patients), although the latter group included a limited number of children.…”

Section: Rr (95% Ci) Pmentioning

confidence: 99%

Hematopoietic stem cell transplantation for children with high-risk acute lymphoblastic leukemia in first complete remission: a report from the AIEOP registry

et al. 2013

View full text Add to dashboard Cite

© F e r r a t a S t o r t i F o u n d a t i o n N o c o m m e r c i a l u s eThe dynamic evolution of the results obtained with chemotherapy protocols has led to relevant modifications of the eligibility criteria for allogeneic hematopoietic stem cell transplantation (HSCT), so that, for instance, patients with B-cell precursor ALL and more than 100x10 9 /L white blood cells at diagnosis not responding to the steroid prephase should not be offered transplantation.Several retrospective studies suggested that allogeneic HSCT from an HLA-identical sibling improves the prognosis of high-risk ALL patients in first complete remission compared with further intensified chemotherapy protocols. [16][17][18][19][20] In 1995, a prospective, cooperative randomized study was carried out through the collaboration between the International Berlin-Frankfurt-Münster (I-BFM) Study Group and the Pediatric Working Party of the European Blood and Marrow Transplantation (EBMT) Group with the aim of comparing the results of allogeneic HSCT from a compatible related donor with those of children with high-risk ALL in first complete remission diagnosed between 1995 and 2000 and treated with chemotherapy alone. 21 In this study, 357 children were enrolled, 280 of whom received chemotherapy while the other 77 were given chemotherapy followed by related-donor HSCT, on the basis of genetic chance (i.e., availability of an HLA-identical donor). The 5-year disease-free survival was 40.6% in children allocated to chemotherapy and 56.7% in those given HSCT (P=0.02). Balduzzi et al. concluded that children with high-risk ALL in first complete remission benefit more from related-donor HSCT than from chemotherapy alone. The gap between the two strategies increases as the risk profile of the patient worsens. Indeed, children who were eligible for the study because of induction failure benefited more than others from related-donor availability. 21Based on the same cohort of patients they had previously analyzed, Balduzzi et al. recently discussed the impact of the time elapsed in first complete remission on prognosis, as well as the potential influence of waiting time to transplantation. The relative advantage of HSCT from compatible related donors in high-risk childhood ALL was found whatever the time elapsed from first complete remission to HSCT. 22The issue of whether patients with high-risk ALL in first complete remission should undergo HSCT from donors other than an HLA-identical sibling remains controversial. The outcome of unrelated donor HSCT has improved greatly in recent years, mostly because of high-resolution HLA-typing and improved prevention/treatment of graftversus-host disease (GvHD). 23,24 In order to further investigate the impact of allogeneic HSCT in high-risk ALL patients, we carried out a retrospective, multicenter study to analyze the outcome of 211 consecutive ALL pediatric patients who underwent HSCT from a related or unrelated donor for ALL in first complete remission and whose data were reported to the Italian Assoc...

show abstract

Conditioning regimens for acute lymphoblastic leukaemia allografts

Cited by 2 publications

References 2 publications

BU- vs TBI-based conditioning for adult patients with ALL

BU- vs TBI-based conditioning for adult patients with ALL

Hematopoietic stem cell transplantation for children with high-risk acute lymphoblastic leukemia in first complete remission: a report from the AIEOP registry

Contact Info

Product

Resources

About