DE Felice Francesca, Grapulin Lavinia, Musio Daniela, Pomponi Jenny, DI Felice Cinzia, Iori Anna Paola, Bertaina Alice, Tombolini Vincenzo
Department of Radiotherapy, Thrombosis Center, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
Department of Radiotherapy, Thrombosis Center, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
Anticancer Res. 2016 Sep;36(9):4859-64. doi: 10.21873/anticanres.11049.
The aim of this study was to evaluate treatment-related toxicity and clinical outcomes of total body irradiation (TBI) in patients with acute lymphoblastic leukemia (ALL).
We performed a retrospective review of all patients with ALL who underwent TBI-based conditioning regimen at our Institution between 2000 and 2012.
A total of 211 patients were included. The median follow-up was 40 months. The 5-year overall survival and disease-free survival were 64.7% and 62.8%, respectively. The 5-year overall survival rate for the 163 children was 67.6% (95% confidence interval=55-77%). Disease status at time of transplant did not improve disease-free survival. Gastrointestinal acute toxicity was the most common early side-effect (19.9%). Acute graft-versus-host disease was reported in 31 patients (14.7%). Main late toxicities were cataract induction (12.8%) and growth, gonadal and endocrine effects (36%).
TBI-based conditioning regimen led to a high survival rate with remarkably low radiation-related toxicity, suggesting that TBI provides a feasible therapeutic option in patients with ALL.
本研究旨在评估急性淋巴细胞白血病（ALL）患者全身照射（TBI）的治疗相关毒性和临床结局。
我们对2000年至2012年间在本机构接受基于TBI预处理方案的所有ALL患者进行了回顾性研究。
共纳入211例患者。中位随访时间为40个月。5年总生存率和无病生存率分别为64.7%和62.8%。163例儿童的5年总生存率为67.6%（95%置信区间=55-77%）。移植时的疾病状态并未改善无病生存率。胃肠道急性毒性是最常见的早期副作用（19.9%）。31例患者（14.7%）报告发生急性移植物抗宿主病。主要的晚期毒性是白内障形成（12.8%）以及生长、性腺和内分泌影响（36%）。
基于TBI的预处理方案导致高生存率且辐射相关毒性极低，表明TBI为ALL患者提供了一种可行的治疗选择。
