Fludarabine or cyclophosphamide in combination with total body irradiation as myeloablative conditioning prior to allogeneic hematopoietic cell transplantation for acute lymphoblastic leukemia: An analysis by the Acute Leukemia Working Party of the EBMT
Standard
Fludarabine or cyclophosphamide in combination with total body irradiation as myeloablative conditioning prior to allogeneic hematopoietic cell transplantation for acute lymphoblastic leukemia: An analysis by the Acute Leukemia Working Party of the EBMT. / Giebel, Sebastian; Labopin, Myriam; Socié, Gerard; Aljurf, Mahmoud; Salmenniemi, Urpu; Labussière-Wallet, Hélène; Srour, Micha; Kröger, Nicolaus; Zahrani, Mohsen Al; Lioure, Bruno; Reményi, Péter; Arat, Mutlu; Bourhis, Jean Henri; Helbig, Grzegorz; Tbakhi, Abdelghani; Forcade, Edouard; Huynh, Anne; Brissot, Eolia; Spirydonidis, Alexandros; Savani, Bipin N; Peric, Zinaida; Nagler, Arnon; Mohty, Mohamad.
in: BONE MARROW TRANSPL, Jahrgang 58, Nr. 5, 05.2023, S. 506-513.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Fludarabine or cyclophosphamide in combination with total body irradiation as myeloablative conditioning prior to allogeneic hematopoietic cell transplantation for acute lymphoblastic leukemia: An analysis by the Acute Leukemia Working Party of the EBMT
AU - Giebel, Sebastian
AU - Labopin, Myriam
AU - Socié, Gerard
AU - Aljurf, Mahmoud
AU - Salmenniemi, Urpu
AU - Labussière-Wallet, Hélène
AU - Srour, Micha
AU - Kröger, Nicolaus
AU - Zahrani, Mohsen Al
AU - Lioure, Bruno
AU - Reményi, Péter
AU - Arat, Mutlu
AU - Bourhis, Jean Henri
AU - Helbig, Grzegorz
AU - Tbakhi, Abdelghani
AU - Forcade, Edouard
AU - Huynh, Anne
AU - Brissot, Eolia
AU - Spirydonidis, Alexandros
AU - Savani, Bipin N
AU - Peric, Zinaida
AU - Nagler, Arnon
AU - Mohty, Mohamad
N1 - © 2023. The Author(s), under exclusive licence to Springer Nature Limited.
PY - 2023/5
Y1 - 2023/5
N2 - In this registry-based study we retrospectively compared outcomes of allogeneic hematopoietic cell transplantation (allo-HCT) for adult patients with acute lymphoblastic leukemia (ALL) following conditioning with total body irradiation (TBI) combined with either cyclophosphamide (Cy) or fludarabine (Flu). TBI 12 Gy + Cy was used in 2105 cases while TBI 12 Gy + Flu was administered to 150 patients in first or second complete remission. In a multivariate model adjusted for other prognostic factors, TBI/Cy conditioning was associated with a reduced risk of relapse (HR = 0.69, p = 0.049) and increased risk of grade 2-4 acute graft-versus-host disease (GVHD, HR = 1.57, p = 0.03) without significant effect on other transplantation outcomes. In a matched-pair analysis the use of TBI/Cy as compared to TBI/Flu was associated with a significantly reduced rate of relapse (18% vs. 30% at 2 years, p = 0.015) without significant effect on non-relapse mortality, GVHD and survival. We conclude that the use of myeloablative TBI/Cy as conditioning prior to allo-HCT for adult patients with ALL in complete remission is associated with lower risk of relapse rate compared to TBI/Flu and therefore should probably be considered a preferable regimen.
AB - In this registry-based study we retrospectively compared outcomes of allogeneic hematopoietic cell transplantation (allo-HCT) for adult patients with acute lymphoblastic leukemia (ALL) following conditioning with total body irradiation (TBI) combined with either cyclophosphamide (Cy) or fludarabine (Flu). TBI 12 Gy + Cy was used in 2105 cases while TBI 12 Gy + Flu was administered to 150 patients in first or second complete remission. In a multivariate model adjusted for other prognostic factors, TBI/Cy conditioning was associated with a reduced risk of relapse (HR = 0.69, p = 0.049) and increased risk of grade 2-4 acute graft-versus-host disease (GVHD, HR = 1.57, p = 0.03) without significant effect on other transplantation outcomes. In a matched-pair analysis the use of TBI/Cy as compared to TBI/Flu was associated with a significantly reduced rate of relapse (18% vs. 30% at 2 years, p = 0.015) without significant effect on non-relapse mortality, GVHD and survival. We conclude that the use of myeloablative TBI/Cy as conditioning prior to allo-HCT for adult patients with ALL in complete remission is associated with lower risk of relapse rate compared to TBI/Flu and therefore should probably be considered a preferable regimen.
KW - Adult
KW - Humans
KW - Whole-Body Irradiation/adverse effects
KW - Retrospective Studies
KW - Transplantation, Homologous/adverse effects
KW - Cyclophosphamide/therapeutic use
KW - Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy
KW - Hematopoietic Stem Cell Transplantation/adverse effects
KW - Leukemia, Myeloid, Acute/complications
KW - Acute Disease
KW - Graft vs Host Disease/etiology
KW - Recurrence
KW - Transplantation Conditioning/adverse effects
U2 - 10.1038/s41409-023-01917-5
DO - 10.1038/s41409-023-01917-5
M3 - SCORING: Journal article
C2 - 36725978
VL - 58
SP - 506
EP - 513
JO - BONE MARROW TRANSPL
JF - BONE MARROW TRANSPL
SN - 0268-3369
IS - 5
ER -