Once-a-day fractionated total-body irradiation: A regimen tailored to local logistics in allogeneic stem cell transplantation for acute lymphoblastic leukemia.
Rep Pract Oncol Radiother
; 25(3): 436-441, 2020.
Article
em En
| MEDLINE
| ID: mdl-32372884
ABSTRACT
AIM:
The objective of the study was to estimate the cumulative incidence (CI) of relapse, relapse-free survival (RFS) and overall survival (OS) in ALL patients after a once-a-day fractionated TBI (F-TBI) regimen with 9.9â¯Gy. The secondary objectives were evaluation of short and long-term toxicity and non-relapse mortality (NRM).BACKGROUND:
Total body irradiation (TBI), as a part of the conditioning regimen before allogeneic stem cell transplantation (ASCT) for acute lymphoblastic leukemia (ALL), allows disease control by eradicating residual blast cells in the transplant recipient. MATERIALS ANDMETHODS:
Retrospective study conducted in patients with ALL who received between March 2003 and December 2013 a conditioning regimen with F-TBI and chemotherapy. Irradiation was delivered with 3.3â¯Gy once-a-day for three consecutive days.RESULTS:
Eighty-seven patients were included. The median age was 19 years (range 5-49 years). The 3-year CI of relapse was 30%. The estimated 3-year RFS and OS were 54% and 58%, respectively. Cumulative incidence of acute graft-versus-host disease (aGVHD) grade II-IV and chronic GVHD (cGVHD) was 31% and 40%, respectively. Interstitial pneumonitis was observed in 2 patients. The 3-year CI of NRM was 16%. In multivariate analysis, cGVHD was associated with a lower CI of relapse (RRâ¯=â¯0.26, 95% CI 0.07-0.95, pâ¯=â¯0.04). High-risk cytogenetics was associated with a lower RFS (RRâ¯=â¯2, 95 CI 1.04-3.84, pâ¯=â¯0.03). Grade II-IV aGVHD was an independent predictor of higher CI of NRM (RRâ¯=â¯6.7, 95% CI 1.4-31.7, pâ¯=â¯0.02).CONCLUSIONS:
Once-a-day F-TBI regimen is effective, safe and practical in patients who underwent ASCT for ALL.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article