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Myeloablative conditioning for allo-HSCT in pediatric ALL: FTBI or chemotherapy?—A multicenter EBMT-PDWP study

by Locatelli, Franco , Rascon Jelena , Afanasyev Boris , Corbacioglu Selim , Michel, Gérard , Nagy Kálmán , Lankester Arjan , Dupont, Sophie , Aleinikova Olga , Jean-Hugues, Dalle , Hamidieh, Amir Ali , Nemet Damir , Willasch Andre Manfred , Buechner Jochen , Styczynski Jan , Jacques-Emmanuel, Galimard , Bierings Marc , Ain, Kaare , Abecasis Manuel , Rose-Marie, Hamladji , Güngör Tayfun , Prete Arcangelo , Fagioli Franca , Campos, Antonio , Ifversen Marianne , Veys, Paul , Or Reuven , Sundin Mikael , Ghavamzadeh Ardeshir , Diaz-de-Heredia, Cristina , Bader, Peter , Sufliarska Sabina , Chybicka Alicja , Wachowiak Jacek , Peters, Christina , Ansari, Marc , Bertrand, Yves , Dalissier Arnaud , Labopin Myriam , Robinson, Stephen , Pichler, Herbert , Bertaina Alice , Vettenranta, Kim , Alseraihy Amal , Skorobogatova Elena , Yesilipek Akif , Alphan, Kupesiz , Sedláček Petr , Kitra-Roussou Vassiliki , Kriván Gergely , Klingebiel, Thomas Erich , Balduzzi, Adriana

in Acute lymphoblastic leukemia / Bone marrow / Chemotherapy / Children / Conditioning / Hematopoietic stem cells / Irradiation / Leukemia / Lymphatic leukemia / Peripheral blood / Radiation / Remission / Stem cell transplantation / Stem cells / Survival / Transplantation

2020

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Myeloablative conditioning for allo-HSCT in pediatric ALL: FTBI or chemotherapy?—A multicenter EBMT-PDWP study

2020

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Myeloablative conditioning for allo-HSCT in pediatric ALL: FTBI or chemotherapy?—A multicenter EBMT-PDWP study

2020

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Journal Article

Myeloablative conditioning for allo-HSCT in pediatric ALL: FTBI or chemotherapy?—A multicenter EBMT-PDWP study

Locatelli, Franco,

Rascon Jelena,

Afanasyev Boris,

Corbacioglu Selim,

Michel, Gérard,

Nagy Kálmán,

Lankester Arjan,

Dupont, Sophie,

Aleinikova Olga,

Jean-Hugues, Dalle,

Hamidieh, Amir Ali,

Nemet Damir,

Willasch Andre Manfred,

Buechner Jochen,

Styczynski Jan,

Jacques-Emmanuel, Galimard,

Bierings Marc,

Ain, Kaare,

Abecasis Manuel,

Rose-Marie, Hamladji,

Güngör Tayfun,

Prete Arcangelo,

Fagioli Franca,

Campos, Antonio,

Ifversen Marianne,

Veys, Paul,

Or Reuven,

Sundin Mikael,

Ghavamzadeh Ardeshir,

Diaz-de-Heredia, Cristina,

Bader, Peter,

Sufliarska Sabina,

Chybicka Alicja,

Wachowiak Jacek,

Peters, Christina,

Ansari, Marc,

Bertrand, Yves,

Dalissier Arnaud,

Labopin Myriam,

Robinson, Stephen,

Pichler, Herbert,

Bertaina Alice,

Vettenranta, Kim,

Alseraihy Amal,

Skorobogatova Elena,

Yesilipek Akif,

Alphan, Kupesiz,

Sedláček Petr,

Kitra-Roussou Vassiliki,

Kriván Gergely,

Klingebiel, Thomas Erich,

Balduzzi, Adriana

2020

Overview

Although 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.

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Publisher

Nature Publishing Group

Subject

Acute lymphoblastic leukemia

/ Hematopoietic stem cells

/ Irradiation