Reduced 8-Gray Compared to Standard 12-Gray Total Body Irradiation for Allogeneic Transplantation in First Remission Acute Lymphoblastic Leukemia : A Study of the Acute Leukemia Working Party of the EBMT
Spyridonidis, Alexandros (University of Patras)
Labopin, Myriam (Sorbonne University)
Savani, Bipin (Vanderbilt University Medical Center)
Giebel, Sebastian (Maria Sklodowska-Curie National Research Institute of Oncology)
Bug, Gesine (Department of Medicine II. Goethe-University)
Schönland, Stefan (Medical Department V. University Hospital Heidelberg)
Kröger, Nicolaus (Department of Stem Cell Transplantation. University Medical Center)
Stelljes, Matthias (Department of Hematology/Oncology. University of Muenster)
Schroeder, Thomas (Department of Bone Marrow Transplantation. University Hospital)
Mcdonald, Andrew (Netcare Pretoria East Hospital)
Blau, Igor-Wolfgang (Charité - Universitätsmedizin Berlin)
Bornhäuser, Martin (University Hospital. TU Dresden)
Rovira, Montse (Institut Germans Trias i Pujol. Institut de Recerca contra la Leucèmia Josep Carreras)
Bethge, Wolfgang (Department of Hematology & Oncology. University Hospital Tuebingen.)
Neubauer, Andreas (Philipps Universitaet Marburg)
Ganser, Arnold (Hannover Medical School)
Bourhis, Jean Henri (Gustave Roussy Cancer Campus BMT. Department of Hematology)
Edinger, Matthias (University Regensburg. Department of Hematology and Oncology)
Lioure, Bruno (Hematology. Stem Cell Transplant Unit. ICANS)
Wulf, Gerald (University Medicine Goettingen)
Schäfer-Eckart, Kerstin (Klinikum Nuernberg. 5. Medizinische Klinik. BMT-Unit)
Arat, Mutlu (Demiroglu Bilim Univ. Istanbul Florence Nightingale Hospital)
Peric, Zinaida (University Hospital Centre)
Schmid, Christoph (Universitatsklinikum Augsburg. Section Stem Cell Transplantation. Augsburg University and Medical Faculty)
Bazarbachi, Ali (Bone Marrow Transplantation Program. Department of Internal Medicine. American University of Beirut-Medical Center)
Ciceri, Fabio (Ospedale San Raffaele)
Nagler, Arnon (Hematology Division. Chaim Sheba Medical Center)
Mohty, Mohamad (Sorbonne Université)

Fecha:	2023
Resumen:	In this registry-based study, we compared outcomes of allogeneic hematopoietic cell transplantation (allo-HCT) in adult patients with acute lymphoblastic leukemia (ALL) transplanted in first complete remission (CR-1), following conditioning with total body irradiation (TBI) at a standard 12-Gray or at a lower 8-Gray total dose. Patients received fludarabine (flu) as the sole chemotherapy complementing TBI. Eight-Gray TBI/flu was used in 494 patients and 12-Gray TBI/flu in 145 patients. Eighty-eight (23. 1%) and 36 (29%) of the patients had Ph-negative B-ALL, 222 (58. 3%) and 53 (42. 7%) had Ph-positive B-ALL, 71 (18. 6%) and 35 (28. 2%) T-ALL, respectively (P = 0. 008). Patients treated with 8-Gray were older than ones received 12-Gray (median 55. 7 versus 40. 3 years, P < 0. 0001) and were more frequently administered in vivo T-cell depletion (71% versus 40%, P <0. 0001). In a multivariate model adjusted for age, type of ALL, and other prognostic factors, leukemia-free survival (primary endpoint) as well as relapse, nonrelapse mortality, overall survival, and GVHD-free, relapse-free survival were not influenced by the TBI dose. These results were confirmed when we focused on patients <55 years of age (median 47 years). Patients with Ph-positive ALL or T-ALL had significantly better survival outcomes than ones with Ph-negative B-ALL, mainly due to significantly fewer relapses. We conclude that 8-Gray TBI is sufficient for adult patients with ALL transplanted in CR-1 with no additional benefit of augmenting the conditioning intensity to 12-Gray.
Nota:	Article Publication Charges are funded by the Institute of Cell Therapy, University Research Center, University of Patras.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Publicado en:	HemaSphere, Vol. 7 Núm. 1 (september 2023) , p. e812, ISSN 2572-9241

DOI: 10.1097/HS9.0000000000000812
PMID: 36698616

9 p, 599.8 KB

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Documentos de investigación > Documentos de los grupos de investigación de la UAB > Centros y grupos de investigación (producción científica) > Ciencias de la salud y biociencias > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP) > Instituto de Investigación contra la Leucemia Josep Carreras
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