Allogeneic stem cell transplant with TBI-based myeloablative conditioning in adolescents and young adults with Philadelphia chromosome-negative ALL treated with pediatric protocols.

Autor: Shimizu H; Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan. Electronic address: hiroakis0825@icloud.com., Kato J; Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan., Tanoue S; Division of Clinical Oncology and Hematology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan., Kimura SI; Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan., Tachibana T; Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan., Hatano K; Division of Hematology, Department of Medicine, Jichi Medical University, Shimotsuke, Japan., Usuki K; Department of Hematology, NTT Medical Center Tokyo, Tokyo, Japan., Taguchi J; Department of Hematology, Japanese Red Cross Shizuoka Hospital, Shizuoka, Japan., Hagihara M; Department of Hematology and Clinical Immunology, Yokohama City University Hospital, Yokohama, Japan., Tsukada N; Department of Hematology, Japanese Red Cross Medical Center, Tokyo, Japan., Harada K; Department of Hematology and Oncology, Tokai University School of Medicine, Kanagawa, Japan., Takahashi S; Division of Molecular Therapy, The Advanced Clinical Research Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan., Takada S; Leukemia Research Center, Saiseikai Maebashi Hospital, Gunma, Japan., Sakaida E; Department of Hematology, Chiba University Hospital, Chiba, Japan., Fujisawa S; Department of Hematology, Yokohama City University Medical Center, Yokohama, Japan., Onoda M; Department of Internal Medicine, Chiba Aoba Municipal Hospital, Chiba, Japan., Aotsuka N; Department of Hematology, Japanese Red Cross Narita Hospital, Narita, Japan., Handa H; Department of Medicine and Clinical Science, Gunma University, Gunma, Japan., Hatta Y; Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan., Nakaseko R; Department of Hematology, Saitama Medical Center, Saitama Medical University, Saitama, Japan., Yano S; Division of Clinical Oncology and Hematology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan., Ohashi K; Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan., Kanda Y; Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan; Division of Hematology, Department of Medicine, Jichi Medical University, Shimotsuke, Japan.
Jazyk: angličtina
Zdroj: Leukemia research [Leuk Res] 2024 Sep; Vol. 144, pp. 107562. Date of Electronic Publication: 2024 Aug 20.
DOI: 10.1016/j.leukres.2024.107562
Abstrakt: To investigate the safety of total body irradiation-based myeloablative conditioning (TBI-MAC) in adolescent and young adult (AYA) Philadelphia chromosome (Ph)-negative acute lymphoblastic leukemia (ALL) patients treated with pediatric protocols, treatment outcomes of 106 AYA patients aged 16-39 years old undergoing allogeneic stem cell transplant (allo-SCT) with TBI-MAC in the first remission were compared according to chemotherapy types before transplant. Pediatric and adult protocols were used in 56 and 50 of the patients, respectively. The cumulative incidence (CI) of non-relapse mortality (NRM) and the overall survival (OS) rates were not significantly different between the pediatric-protocol and adult-protocol group (NRM: 4 % vs. 14 % at five years post-transplant, respectively, p = 0.26; OS: 81 % vs. 66 %, respectively, p = 0.14). Multivariate analysis for NRM revealed that a performance status >0 (hazard ratio [HR] = 4.8) and transplant due to chemotherapy toxicities (HR = 3.5) were independent risk factors, but a pediatric protocol was not (HR = 0.48). The CI of NRM and the OS rates were also similar among patients aged over 24 years old. These findings suggested that conventional allo-SCT with TBI-MAC can be performed without increasing NRM in AYA patients with Ph-negative ALL even after pediatric protocols.
Competing Interests: Declaration of Competing Interest The authors declare no competing financial interests.
(Copyright © 2024 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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