Comparison of total body irradiation versus non-total body irradiation containing regimens for de novo acute myeloid leukemia in children
Year: 2020
Type: article
Study design: Observational Study
Abstract: With limited data comparing hematopoietic cell transplant outcomes between myeloablative total body irradiation (TBI) containing and non-TBI regimens in children with de novo acute myeloid leukemia, the aim of this study was to compare transplant-outcomes between these regimens. Cox regression models were used to compare transplant-outcomes after TBI and non-TBI regimens in 624 children transplanted between 2008 and 2016. Thirty two percent (n=199) received TBI regimens whereas 68% (n=425) received non-TBI regimens. Five-year non-relapse mortality was higher with TBI regimens (22% vs. 11%, p<0.0001) but relapse was lower (23% vs. 37%, p<0.0001) compared to non-TBI regimens. Consequently, overall (62% vs. 60%, p=1.00) and leukemia-free survival (55% vs. 52%, p=0.42) did not differ between treatment groups. Grade II-IV acute GVHD was higher with TBI regimens (56% vs. 27%, p<0.0001) but not chronic GVHD. The 3-year incidence of gonadal or growth hormone deficiency was higher with TBI regimens (24% vs. 8%, p<0.001) but there were no differences in late pulmonary, cardiac or renal impairment. In the absence of a survival advantage, the choice of TBI or non-TBI regimen merits careful consideration with the data favoring non-TBI regimens to limit the burden of morbidity associated with endocrine dysfunction.
Source: Haematologica
Authors: Christopher E. Dandoy, Stella M. Davies, Kwang Woo Ahn, Yizeng He, Anders E. Kolb, John Levine, Stephanie Bo-Subait, Hisham Abdel-Azim, Neel Bhatt, Joseph Chewing, Shahinaz Gadalla, Nicholas Gloude, Robert Hayashi, Nahal R. Lalefar, Jason Law, Margaret MacMillan, Tracy O'Brien, Timothy Prestidge, Akshay Sharma, Peter Shaw, Lena Winestone, Mary Eapen
Institutions: Cincinnati Children's Hospital Medical Center, Medical College of Wisconsin, Alfred I. duPont Hospital for Children, Icahn School of Medicine at Mount Sinai, National Marrow Donor Program, University of Southern California, Children's Hospital Los Angeles, Fred Hutch Cancer Center, University of Alabama at Birmingham, National Institutes of Health, National Cancer Institute, Division of Cancer Epidemiology and Genetics, Rady Children's Hospital-San Diego, Washington University in St. Louis, Tufts Medical Center, University of Minnesota, Sydney Children's Hospital, Starship Children's Health, St. Jude Children's Research Hospital, Children's Hospital at Westmead, Children's Hospital of Philadelphia
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,157
OpenAlex ID: W3036176758