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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
Show Affiliations
Authors Affiliations
  1. 1. Division for Stem Cell Transplantation and Immunology, Department for Children and Adolescents, University Hospital, Goethe University Frankfurt, Frankfurt, Germany
  2. 2. St. Anna Children’s Hospital, Department of Pediatrics, Medical University of Vienna, Vienna, Austria
  3. 3. Department of Pediatric Hematology and Oncology, University Hospital Motol, Prague, Czech Republic
  4. 4. Department of Pediatric Hemato–Immunology, Hopital Robert Debre and Universite de Paris, Paris, France
  5. 5. Stem Cell Transplant Unit, Aghia Sophia Children’s Hospital, Thivon and Papadiamantopoulou, Athens, Greece
  6. 6. Department of Pediatric Hematology and Stem Cell Transplantation Unit, Medicalpark Antalya Hastanesi, Antalya, Turkey
  7. 7. Department of Pediatric Oncology, Hematology and Transplantology, University of Medical Sciences, Poznan, Poland
  8. 8. Department of Pediatrics, Leiden University Medical Center, Leiden, Netherlands
  9. 9. Hematology–Oncology Unit “Lalla Seragnoli�, Department of Pediatrics, University of Bologna, Bologna, Italy
  10. 10. Pediatric Cell Therapy Research Center, Tehran University of Medical Sciences, Tehran, Iran
  11. 11. Department of Pediatrics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
  12. 12. Department of Pediatric Hematology and Oncology, Oslo University Hospital, Oslo, Norway
  13. 13. Department for Pediatric Hematology and Hemopoietic Stem Cell Transplantation, Central Hospital of Southern Pest, National Institute of Hematology and Infectious Diseases, United St. Istvan and St. Laszlo Hospital, Budapest, Hungary
  14. 14. Centre Pierre et Marie Curie, Service Hematologie Greffe de Moelle, Alger, Algeria
  15. 15. Servicio de Hematologia y Oncologia Pediatricas, Hospital Universitario Vall d’Hebron, Barcelona, Spain
  16. 16. BMT Department, Russian Children’s Hospital, Moscow, Russian Federation
  17. 17. Department of Pediatric Hematology and Oncology and Research Unit EA 3279, Timone Enfants Hospital, AP-HM and Aix-Marseille University, Marseille, France
  18. 18. Dipartimento di Onco-Ematologia e Terapia Cellulare e Genica, IRCCS Ospedale Pediatrico Bambino Gesu, Rome, Italy
  19. 19. Dipartimento Materno-Infantile e Scienze Urologiche, Sapienza University of Rome, Rome, Italy
  20. 20. Division of Stem Cell Transplantation and Regenerative Medicine, Department of Pediatrics, School of Medicine, Stanford University, Stanford, CA, United States
  21. 21. Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
  22. 22. Department of Pediatric Hematology and Oncology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
  23. 23. Department of Bone Marrow Transplantation, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
  24. 24. Division of Stem Cell Transplantation, Children’s Research Center (CRC), University Children’s Hospital, Zurich, Switzerland
  25. 25. Republic Clinical Research Centre for Pediatric Oncology and Hematology, Minsk, Belarus
  26. 26. BMT Unit, Department of Pediatric Hematology and Oncology, Comenius University Medical School, Limbova, Bratislava, Slovakia
  27. 27. Division of Pediatrics, CLINTEC, Karolinska Institutet and Pediatric Hematology, Immunology and HCT, Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden
  28. 28. Center of Pediatric Oncology and Hematology, Vilnius University, Vilnius, Lithuania
  29. 29. Tartu University Hospital, Tartu, Estonia
  30. 30. Department of Haematology, Internal Clinic, University Hospital Centre, Zagreb, Croatia
  31. 31. Paediatric Onco-Haematology, City of Science and Health of Turino, Regina Margherita Children’s Hospital, Torino, Italy
  32. 32. Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz, Poland
  33. 33. BMT-Unit, University Medical Centre Utrecht Pediatrics, Utrecht, Netherlands
  34. 34. Department of Hematology, Child Welfare Center, Borsod County Teaching Hospital, Miskolc, Hungary
  35. 35. Bone Marrow Transplant Program, Instituto Portugues Oncologia, Lisbon, Portugal
  36. 36. Raisa Gorbacheva Memorial Research Institute for Pediatric Oncology, Haematology and Transplantation, Saint Petersburg State Medical I.P. Pavlov University, Saint Petersburg, Russian Federation
  37. 37. Department of Pediatrics, Onco-Hematology Unit, Geneva University Hospital, Geneva University, Geneva, Switzerland
  38. 38. Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland
  39. 39. Department of Pediatric Hematology Oncology, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
  40. 40. Department of Bone Marrow Transplantation, Oncology and Hematology, Cape of Hope Medical Center, Wroclaw Medical University, Wroclaw, Poland
  41. 41. University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom
  42. 42. Department of Pediatric Hematology and BMT, IHOP and Claude Bernard University, Lyon, France
  43. 43. Department of Pediatric Hematology–Oncology, School of Medicine, Akdeniz University, Antalya, Turkey
  44. 44. Hematology-Oncology and BMT Research, Shariati Hospital, Tehran, Iran
  45. 45. Bone Marrow Transplantation Service, Portuguese Institute of Oncology, Porto, Portugal
  46. 46. EBMT Paediatric Diseases Working Party, Paris, France
  47. 47. EBMT Paris Study Office, Paris, France
  48. 48. Department of Pediatric Hematology, Oncology and Stem Cell Transplantation, University of Regensburg, Regensburg, Germany
  49. 49. Bone Marrow Transplantation Unit, Pediatric Department of Milano-Bicocca University, Fondazione Monza e Brianza per il Bambino e la sua Mamma Foundation, Monza, Italy

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.