Myeloablative conditioning for allo-HSCT in pediatric ALL: FTBI or chemotherapy?—A multicenter EBMT-PDWP study
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Published:2020-03-17
Issue:8
Volume:55
Page:1540-1551
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ISSN:0268-3369
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Container-title:Bone Marrow Transplantation
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language:en
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Short-container-title:Bone Marrow Transplant
Author:
Willasch Andre ManfredORCID, Peters ChristinaORCID, Sedláček Petr, Dalle Jean-HuguesORCID, Kitra-Roussou Vassiliki, Yesilipek Akif, Wachowiak Jacek, Lankester Arjan, Prete Arcangelo, Hamidieh Amir Ali, Ifversen Marianne, Buechner JochenORCID, Kriván Gergely, Hamladji Rose-Marie, Diaz-de-Heredia CristinaORCID, Skorobogatova Elena, Michel Gérard, Locatelli Franco, Bertaina Alice, Veys Paul, Dupont Sophie, Or Reuven, Güngör TayfunORCID, Aleinikova Olga, Sufliarska Sabina, Sundin Mikael, Rascon JelenaORCID, Kaare AinORCID, Nemet Damir, Fagioli FrancaORCID, Klingebiel Thomas Erich, Styczynski JanORCID, Bierings Marc, Nagy Kálmán, Abecasis Manuel, Afanasyev Boris, Ansari Marc, Vettenranta Kim, Alseraihy Amal, Chybicka Alicja, Robinson Stephen, Bertrand Yves, Kupesiz Alphan, Ghavamzadeh Ardeshir, Campos Antonio, Pichler HerbertORCID, Dalissier Arnaud, Labopin Myriam, Corbacioglu Selim, Balduzzi AdrianaORCID, Galimard Jacques-EmmanuelORCID, Bader Peter,
Abstract
AbstractAlthough most children with acute lymphoblastic leukemia (ALL) receive fractionated total body irradiation (FTBI) as myeloablative conditioning (MAC) for allogeneic hematopoietic stem cell transplantation (allo-HSCT), it is an important matter of debate if chemotherapy can effectively replace FTBI. To compare outcomes after FTBI versus chemotherapy-based conditioning (CC), we performed a retrospective EBMT registry study. Children aged 2–18 years after MAC for first allo-HSCT of bone marrow (BM) or peripheral blood stem cells (PBSC) from matched-related (MRD) or unrelated donors (UD) in first (CR1) or second remission (CR2) between 2000 and 2012 were included. Propensity score weighting was used to control pretreatment imbalances of the observed variables. 3.054 patients were analyzed. CR1 (1.498): median follow-up (FU) after FTBI (1.285) and CC (213) was 6.8 and 6.1 years. Survivals were not significantly different. CR2 (1.556): median FU after FTBI (1.345) and CC (211) was 6.2 years. Outcomes after FTBI were superior as compared with CC with regard to overall survival (OS), leukemia-free survival (LFS), relapse incidence (RI), and nonrelapse mortality (NRM). However, we must emphasize the preliminary character of the results of this retrospective “real-world-practice” study. These findings will be prospectively assessed in the ALL SCTped 2012 FORUM trial.
Publisher
Springer Science and Business Media LLC
Subject
Transplantation,Hematology
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