Department of Pediatric Hematology and Oncology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University Torun, Jurasz University Hospital 1, Bydgoszcz, Poland;
Department of Pediatric Hematology and Oncology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University Torun, Jurasz University Hospital 1, Bydgoszcz, Poland.
In Vivo. 2021 Nov-Dec;35(6):3315-3320. doi: 10.21873/invivo.12627.
BACKGROUND/AIM: Comparison of transplant outcomes in long-term follow-up of children after total body irradiation (TBI)- or chemotherapy-based conditioning allogeneic hematopoietic cell transplantation (allo-HCT).
Patients undergoing allo-HCT for Acute lymphoblastic leukemia (ALL) conditioned either with TBI (n=55) or chemotherapy (n=84) were compared. The following transplant outcomes were analyzed: overall survival (OS), event-free survival (EFS), relapse incidence (RI), and graft-versus-host-disease (GVHD)-free-relapse-free survival (GRFS).
All analyzed long-term transplant outcomes were significantly better for patients conditioned with TBI at 2 years after transplant. OS at 2 years was 84% after TBI and 60.5% after chemotherapy-conditioning (p=0.005). Risk factor analysis showed that two factors, TBI-based conditioning and transplant in first remission of ALL, significantly improved OS, EFS, GRFS, and decreased RI.
TBI-based conditioning before allogeneic HCT in children with acute lymphoblastic leukemia provides significantly better transplant outcomes, when compared to chemotherapy-based conditioning.
背景/目的：比较全身照射（TBI）或基于化疗的预处理异基因造血细胞移植（allo-HCT）后儿童长期随访中的移植结果。
比较了接受 TBI（n=55）或化疗（n=84）预处理的急性淋巴细胞白血病（ALL）allo-HCT 的患者。分析了以下移植结果：总生存（OS）、无事件生存（EFS）、复发率（RI）和移植物抗宿主病（GVHD）-无复发生存（GRFS）。
移植 2 年后，TBI 预处理患者的所有分析长期移植结果均显著优于化疗预处理患者。TBI 后 2 年 OS 为 84%，化疗后为 60.5%（p=0.005）。风险因素分析表明，TBI 预处理和 ALL 首次缓解期的移植这两个因素显著改善了 OS、EFS、GRFS，降低了 RI。
与基于化疗的预处理相比，TBI 预处理在儿童急性淋巴细胞白血病的异基因造血细胞移植中提供了更好的移植结果。
