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Acute Lymphoblastic Leukemia in Children: Better Transplant Outcomes After Total Body Irradiation-based Conditioning. 2021
Jan Styczynski, and
Robert Debski, and
Krzysztof Czyzewski, and
Katarzyna Gagola, and
Ewa Marquardt, and
Krzysztof Roszkowski, and
Janusz Winiecki, and
Ninela Irga-Jaworska, and
Marcin Hennig, and
Katarzyna Muszynska-Roslan, and
Marcin Plonowski, and
Tomasz Ociepa, and
Monika Lecka, and
Joanna Konieczek, and
Przemyslaw Galazka, and
Monika Pogorzala, and
Monika Richert-Przygonska, and
Mariusz Wysocki
Department of Pediatric Hematology and Oncology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University Torun, Jurasz University Hospital 1, Bydgoszcz, Poland; jstyczynski@cm.umk.pl.
OBJECTIVE 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). METHODS 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). RESULTS 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. CONCLUSIONS TBI-based conditioning before allogeneic HCT in children with acute lymphoblastic leukemia provides significantly better transplant outcomes, when compared to chemotherapy-based conditioning.
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