Comparative outcome of hematopoietic stem cell transplantation for pediatric acute lymphoblastic leukemia following cyclophosphamide and total body irradiation or VP16 and total body irradiation conditioning regimens
Comparative outcome of hematopoietic stem cell transplantation for pediatric acute lymphoblastic leukemia following cyclophosphamide and total body irradiation or VP16 and total body irradiation conditioning regimens
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DOI：
10.1038/sj.bmt.1705515
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发表时间：
2006-12-01
影响因子：
4.8
通讯作者：
Doyle, J. J.
中科院分区：
文献类型：
--
作者：
Gassas, A.;Sung, L.;Doyle, J. J.
比较儿童急性淋巴细胞白血病（ALL）中造血干细胞移植（HSCT）的结局，两种不同的方案为：（1）单剂量VP 16（60 mg/kg，4 h）和全身照射（TBI; 1200 cGy，分6次）或（2）环磷酰胺50 mg/kg，每日1 h，持续4天，随后进行相同剂量的TBI。从1990年到2003年，107名ALL儿童在多伦多儿童医院接受了完全匹配的HSCT。所有患者均接受环孢菌素A和短期甲氨蝶呤预防移植物抗宿主病（GVHD）。VP 16组有36例匹配的亲缘供者移植（MRD）和26例匹配的非亲缘供者移植（MUD）;环磷酰胺组有23例MRD和22例MUD。对于VP 16/TBI和CY/TBI组，中性粒细胞植入分别发生在中位数18天和17天。接受VP 16/TBI组的3年无事件生存率和总生存率分别为47 +/- 7和55 +/- 7%，CY/TBI组为5178和53 +/- 8%。两组间急性或慢性GVHD的患病率和移植相关死亡率无显著差异。VP 16/FTBI和CY/FTBI方案是同样有效的方案。
To compare the outcome of hematopoietic stem cell transplantation (HSCT) in pediatric acute lymphoblastic leukemia (ALL) conditioned with two different regimens: (1) single dose of VP16 (60 mg/kg over 4 h) and total body irradiation (TBI; 1200 cGy, in six fractions) or (2) Cyclophosphamide 50 mg/kg over 1 h daily for 4 days followed by the same dose of TBI. One hundred and seven children with ALL received fully matched HSCT from 1990 to 2003 in the Hospital for Sick Children, Toronto. All received cyclosporin A and a short course of methotrexate for graft-versus-host disease (GVHD) prophylaxis. The VP16 group, there were 36 matched related donor transplants (MRD) and 26 matched unrelated donor transplants ( MUD), and in the cyclophosphamide group there were 23 MRD and 22 MUD transplants. Neutrophil engraftment occurred at a median of 18 and 17 days for the VP16/TBI and the CY/TBI groups, respectively. The 3 year event-free survival and overall survival were 47 +/- 7 and 55 +/- 7% for those receiving VP16/TBI, and 5178 and 53 +/- 8% for the CY/TBI group. There were no significant differences in the prevalence of acute or chronic GVHD and transplant-related mortality between the two groups. Both VP16/FTBI and CY/FTBI regimen are equally effective regimens.