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Reduced-intensity conditioning followed by allogeneic transplantation in pediatric malignancies: a report from the Société Française des Cancers de l’Enfant and the Société Française de Greffe de Moelle et de Thérapie Cellulaire
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Reduced-intensity conditioning followed by allogeneic transplantation in pediatric malignancies: a report from the Société Française des Cancers de l’Enfant and the Société Française de Greffe de Moelle et de Thérapie Cellulaire
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Reduced-intensity conditioning followed by allogeneic transplantation in pediatric malignancies: a report from the Société Française des Cancers de l’Enfant and the Société Française de Greffe de Moelle et de Thérapie Cellulaire
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Journal Article
Reduced-intensity conditioning followed by allogeneic transplantation in pediatric malignancies: a report from the Société Française des Cancers de l’Enfant and the Société Française de Greffe de Moelle et de Thérapie Cellulaire
2013
Overview
We report French prospective experience with reduced-intensity conditioning–allo-SCT in 46 patients (median age: 15.5 years, 4.8–20.2) presenting high-risk AL (
n
=11), Hodgkin’s lymphoma (
n
=15) or solid tumors (
n
=20). Graft sources were BM (
n
=21), PBSC (
n
=20) and cord blood (CB;
n
=5) from related (
n
=20) or unrelated (
n
=26) donors. For CB grafts, only one patient out of five achieved sustained engraftment. For PBSC/BM grafts, engraftment rate was 95%, hematopoietic recovery times were not significantly different between BM, PBSC, sibling or unrelated grafts, day+100. Full donor chimerism was achieved in 94% of patients, and incidences of primary acute GVHD and chronic GVHD were 49% and 14%, respectively. Underlying disease was fatal in 39% of patients. TRM was 6.9%. Three-year OS was 49.15%. OS and EFS were not significantly different between patients transplanted with different grafts and with or without primary GVHD. Patients with solid tumor or measurable disease at transplant had poorer outcomes. Three-year EFS: 33.3% for ALL, 75.0% for AML, 51.8% for Hodgkin’s lymphoma, 28.6% for neuroblastoma and 22.2% for sarcoma patients. This multicentre study concluded that Bu/fludarabine/anti-thymocyte globulin conditioning with PB or BM, related or unrelated grafts in patients with various malignancies at high-risk for transplantation toxicity results in high engraftment rates, low TRM and acceptable survival.
Publisher
Nature Publishing Group UK,Nature Publishing Group
Subject
/ Adult
/ Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
/ Biological and medical sciences
/ Bone marrow, stem cells transplantation. Graft versus host reaction
/ Child
/ Female
/ France
/ Grafting
/ Hematopoietic Stem Cell Transplantation - methods
/ Humans
/ Lymphoma
/ Male
/ Medicine
/ Multiple tumors. Solid tumors. Tumors in childhood (general aspects)
/ Patients
/ Sarcoma
/ Testing
/ Toxicity
/ Transfusions. Complications. Transfusion reactions. Cell and gene therapy
/ Transplantation Conditioning - methods
/ Tumors
