Safety and efficacy of total body irradiation, cyclophosphamide, and cytarabine as a conditioning regimen for allogeneic hematopoietic stem cell transplantation in patients with acute lymphoblastic leukemia
Safety and efficacy of total body irradiation, cyclophosphamide, and cytarabine as a conditioning regimen for allogeneic hematopoietic stem cell transplantation in patients with acute lymphoblastic leukemia
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DOI：
10.1002/ajh.23109
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发表时间：
2012-04-01
影响因子：
12.8
通讯作者：
Okamoto, Shinichiro
中科院分区：
文献类型：
--
作者：
Mori, Takehiko;Aisa, Yoshinobu;Okamoto, Shinichiro
疾病复发仍然是影响异基因造血干细胞移植(HSCT)治疗急性淋巴细胞白血病(ALL)的重要因素。这项研究回顾了包括全身照射(12Gy)、环磷酰胺(CY；60 mg kg-1，两次剂量)和大剂量阿糖胞苷(Ara-C；2gm-(2)；四次剂量)的预适应方案对ALL患者的长期安全性和有效性。55名患者(中位年龄：31岁)接受了评估。22名患者的干细胞来自人类白细胞抗原相合的兄弟姐妹，33名患者来自替代捐赠者。移植前无早期死亡病例，100天移植相关死亡率为7.3%。中位随访期9.6年，完全缓解组5年总生存率和无病生存率分别为63.2%(95%CI：46.579.9%)和63.6%(95%CI：47.180.1%)，均显著高于晚期患者的27.3%(95%CI：8.746.0%)和22.7%(95%CI：5.340.1%)(P<；0.01)。这些结果表明，TBI和CY(TBI-CY)联合Ara-C方案可能是治疗成人ALL缓解期和晚期ALL的一种可行而有效的调节方案，还需要进一步的研究将其与TBI-CY相比较。上午好。J.血醇。2012年。(C)2011年威利期刊公司。
Disease relapse still greatly interferes with the success of allogeneic hematopoietic stem cell transplantation (HSCT) for acute lymphoblastic leukemia (ALL). This study retrospectively evaluated the long-term safety and efficacy of a conditioning regimen consisting of total body irradiation (TBI; 12 Gy), cyclophosphamide (CY; 60 mg kg-1, two doses), and high-dose cytarabine (Ara-C; 2 g m-(2); four doses) for patients with ALL. Fifty-five patients (median age: 31-years old) were evaluated. Stem cells were from human leukocyte antigen-identical siblings in 22 patients and from alternative donors in 33. There were no cases of early death before engraftment, and 100-day transplant-related mortality was 7.3%. With a median follow-up period of 9.6 years, 5-year overall and disease-free survival were 63.2% (95% CI: 46.579.9%) and 63.6% (95% CI: 47.180.1%) in patients with complete remission, respectively, both of which were significantly higher than the values of 27.3% (95% CI: 8.746.0%) and 22.7% (95% CI: 5.340.1%) for patients in advanced stages (P < 0.01). These results suggest that TBI and CY (TBI-CY) plus Ara-C could be a feasible and effective conditioning regimen for adult patients with ALL both in remission and in advanced stages, and a future study to compare this combination therapy with TBI-CY is required. Am. J. Hematol. 2012. (C) 2011 Wiley Periodicals, Inc.