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Myeloablative Conditioning for Allo-Hsct in Pediatric All: Ftbi or Chemotherapy?—A Multicenter Ebmt-Pdwp Study Publisher Pubmed



Willasch AM1 ; Peters C2 ; Sedlacek P3 ; Dalle JH4 ; Kitraroussou V5 ; Yesilipek A6 ; Wachowiak J7 ; Lankester A8 ; Prete A9 ; Hamidieh AA10 ; Ifversen M11 ; Buechner J12 ; Krivan G13 ; Hamladji RM14 Show All Authors
Authors
  1. Willasch AM1
  2. Peters C2
  3. Sedlacek P3
  4. Dalle JH4
  5. Kitraroussou V5
  6. Yesilipek A6
  7. Wachowiak J7
  8. Lankester A8
  9. Prete A9
  10. Hamidieh AA10
  11. Ifversen M11
  12. Buechner J12
  13. Krivan G13
  14. Hamladji RM14
  15. Diazdeheredia C15
  16. Skorobogatova E16
  17. Michel G17
  18. Locatelli F18, 19
  19. Bertaina A18, 19, 20
  20. Veys P21
  21. Dupont S22
  22. Or R23
  23. Gungor T24
  24. Aleinikova O25
  25. Sufliarska S26
  26. Sundin M27
  27. Rascon J28
  28. Kaare A29
  29. Nemet D30
  30. Fagioli F31
  31. Klingebiel TE1
  32. Styczynski J32
  33. Bierings M33
  34. Nagy K34
  35. Abecasis M35
  36. Afanasyev B36
  37. Ansari M37
  38. Vettenranta K38
  39. Alseraihy A39
  40. Chybicka A40
  41. Robinson S41
  42. Bertrand Y42
  43. Kupesiz A43
  44. Ghavamzadeh A44
  45. Campos A45
  46. Pichler H2
  47. Dalissier A46
  48. Labopin M47
  49. Corbacioglu S48
  50. Balduzzi A49
  51. Galimard JE46
  52. Bader P1

Source: Bone Marrow Transplantation Published:2020


Abstract

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. © 2020, The Author(s), under exclusive licence to Springer Nature Limited.
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