Transplantation conditioning regimens and outcomes after allogeneic hematopoietic cell transplantation in children and adolescents with acute lymphoblastic leukemia.
Transplantation conditioning regimens and outcomes after allogeneic hematopoietic cell transplantation in children and adolescents with acute lymphoblastic leukemia.
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DOI：
10.1016/j.bbmt.2012.09.019
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发表时间：
2013-02
影响因子：
4.3
通讯作者：
Eapen, Mary
中科院分区：
文献类型：
--
作者：
Tracey, James;Zhang, Mei-Jie;Thiel, Elizabeth;Sobocinski, Kathleen A.;Eapen, Mary
Relapse is common after hematopoietic cell transplantation for acute lymphoblastic leukemia (ALL). While 1200 cGy total body irradiation (TBI) and cyclophosphamide (Cy) is standard, attempts to lower relapse have led to the addition of a second chemotherapeutic agent and/or higher dose TBI. We examined transplantation outcomes in patients aged <18 years with ALL, in second or subsequent remission or in relapse at transplantation. Most transplants occurred in remission. Patients received grafts from an HLA-matched sibling or unrelated donor. Four treatment groups were created: 1) Cy + TBI≤1200 cGy (n=304), 2) Cy + etoposide + TBI≤1200 cGy (n=108), 3) Cy + TBI≥1300 cGy (n=327), and 4) Cy + etoposide + TBI≥1300 cGy (n=26). Neither TBI in excess of 1200 cGy nor the addition of etoposide resulted in fewer relapses. The 5-year probabilities of relapse were 30%, 28%, 35% and 31% for groups 1, 2, 3 and 4, respectively. However, transplant-related mortality was higher (35% vs. 25%, p=0.02) and overall survival lower (36% vs. 48%, p=0.03) after Cy + etoposide + TBI ≥1300 cGy compared to Cy + TBI ≥1300 cGy. Compared to the standard regimen neither TBI in excess of 1200cGy nor the addition of etoposide improves survival after HCT for ALL.
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影响因子：
20.3
作者：
Eapen, M;Raetz, E;Davies, SM
通讯作者：
Davies, SM
影响因子：
20.3
作者：
Rizzo, J. Douglas;Curtis, Rochelle E.;Deeg, H. Joachim
通讯作者：
Deeg, H. Joachim
影响因子：
4.8
作者：
Gassas, A.;Sung, L.;Doyle, J. J.
通讯作者：
Doyle, J. J.
影响因子：
20.3
作者：
Borgmann, A;von Stackelberg, A;Henze, G
通讯作者：
Henze, G
影响因子：
4.3
作者：
Marks, DI;Forman, SJ;Horowitz, MM
通讯作者：
Horowitz, MM