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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

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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, Vol. 58, No. 5, 05.2023, p. 506-513.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Giebel, S, Labopin, M, Socié, G, Aljurf, M, Salmenniemi, U, Labussière-Wallet, H, Srour, M, Kröger, N, Zahrani, MA, Lioure, B, Reményi, P, Arat, M, Bourhis, JH, Helbig, G, Tbakhi, A, Forcade, E, Huynh, A, Brissot, E, Spirydonidis, A, Savani, BN, Peric, Z, Nagler, A & Mohty, M 2023, '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', BONE MARROW TRANSPL, vol. 58, no. 5, pp. 506-513. https://doi.org/10.1038/s41409-023-01917-5

APA

Giebel, S., Labopin, M., Socié, G., Aljurf, M., Salmenniemi, U., Labussière-Wallet, H., Srour, M., Kröger, N., Zahrani, M. A., Lioure, B., Reményi, P., Arat, M., Bourhis, J. H., Helbig, G., Tbakhi, A., Forcade, E., Huynh, A., Brissot, E., Spirydonidis, A., ... Mohty, M. (2023). 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. BONE MARROW TRANSPL, 58(5), 506-513. https://doi.org/10.1038/s41409-023-01917-5

Vancouver

Giebel S, Labopin M, Socié G, Aljurf M, Salmenniemi U, Labussière-Wallet H et al. 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. BONE MARROW TRANSPL. 2023 May;58(5):506-513. https://doi.org/10.1038/s41409-023-01917-5

Bibtex

@article{a3e3279896af40e2af72bd68f9e01c97,
title = "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",
abstract = "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.",
keywords = "Adult, Humans, Whole-Body Irradiation/adverse effects, Retrospective Studies, Transplantation, Homologous/adverse effects, Cyclophosphamide/therapeutic use, Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy, Hematopoietic Stem Cell Transplantation/adverse effects, Leukemia, Myeloid, Acute/complications, Acute Disease, Graft vs Host Disease/etiology, Recurrence, Transplantation Conditioning/adverse effects",
author = "Sebastian Giebel and Myriam Labopin and Gerard Soci{\'e} and Mahmoud Aljurf and Urpu Salmenniemi and H{\'e}l{\`e}ne Labussi{\`e}re-Wallet and Micha Srour and Nicolaus Kr{\"o}ger and Zahrani, {Mohsen Al} and Bruno Lioure and P{\'e}ter Rem{\'e}nyi and Mutlu Arat and Bourhis, {Jean Henri} and Grzegorz Helbig and Abdelghani Tbakhi and Edouard Forcade and Anne Huynh and Eolia Brissot and Alexandros Spirydonidis and Savani, {Bipin N} and Zinaida Peric and Arnon Nagler and Mohamad Mohty",
note = "{\textcopyright} 2023. The Author(s), under exclusive licence to Springer Nature Limited.",
year = "2023",
month = may,
doi = "10.1038/s41409-023-01917-5",
language = "English",
volume = "58",
pages = "506--513",
journal = "BONE MARROW TRANSPL",
issn = "0268-3369",
publisher = "NATURE PUBLISHING GROUP",
number = "5",

}

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 -