Article (Scientific journals)
The Sequence of Cyclophosphamide and Myeloablative Total Body Irradiation in Hematopoietic Cell Transplantation for Patients with Acute Leukemia
Holter-Chakrabarty, Jennifer; Pierson, Namali; Zhang, Mei-Jie et al.
2015In Biology of Blood and Marrow Transplantation, 21 (7), p. 1251-7
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Keywords :
Allogeneic transplantation; Total body irradiation; Leukemia
Abstract :
[en] Limited clinical data are available to assess whether the sequencing of cyclophosphamide (Cy) and total body irradiation (TBI) changes outcomes. We evaluated the sequence in 1769 (CyTBI, n ¼ 948; TBICy, n ¼ 821) recipients of related or unrelated hematopoietic cell transplantation who received TBI (1200 to 1500 cGY) for acute leukemia from 2003 to 2010. The 2 cohorts were comparable for median age, performance score, type of leukemia, first complete remission, Philadelphia chromosomeepositive acute lymphoblastic leukemia, HLAmatched siblings, stem cell source, antithymocyte globulin use, TBI dose, and type of graft-versus-host disease (GVHD) prophylaxis. The sequence of TBI did not significantly affect transplantation-related mortality (24% versus 23% at 3 years, P ¼.67; relative risk, 1.01; P ¼.91), leukemia relapse (27% versus 29% at 3 years, P ¼ .34; relative risk, .89, P ¼.18), leukemia-free survival (49% versus 48% at 3 years, P ¼.27; relative risk, .93; P ¼ .29), chronic GVHD (45% versus 47% at 1 year, P ¼.39; relative risk, .9; P ¼ .11), or overall survival (53% versus 52% at 3 years, P ¼.62; relative risk, .96; P ¼.57) for CyTBI and TBICy, respectively. Corresponding cumulative incidences of sinusoidal obstruction syndrome were 4% and 6% at 100 days (P ¼ .08), respectively. This study demonstrates that the sequence of Cy and TBI does not impact transplantation outcomes and complications in patients with acute leukemia undergoing hematopoietic cell transplantation with myeloablative conditioning.
Disciplines :
Hematology
Author, co-author :
Holter-Chakrabarty, Jennifer
Pierson, Namali
Zhang, Mei-Jie
Zhu, Xiaochun
Akpek, Görgün
Aljurf, Mahmoud
Artz, Andrew
Baron, Frédéric  ;  Université de Liège > GIGA-R : Hématologie
Bredeson, Christopher
Dvorak, Christopher
Epstein, Robert
Lazarus, Hillard
Olsson, Richard
Selby, George
Williams, Kirsten
Cooke, Kenneth
Pasquini, Marcelo
McCarthy, Philip
More authors (8 more) Less
Language :
English
Title :
The Sequence of Cyclophosphamide and Myeloablative Total Body Irradiation in Hematopoietic Cell Transplantation for Patients with Acute Leukemia
Publication date :
July 2015
Journal title :
Biology of Blood and Marrow Transplantation
ISSN :
1083-8791
eISSN :
1523-6536
Publisher :
Carden Jennings Publishing, Charlottesville, United States - Virginia
Volume :
21
Issue :
7
Pages :
1251-7
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 04 June 2015

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