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A comparison of cyclophosphamide and total body irradiation with etoposide and total body irradiation as conditioning regimens for patients undergoing sibling allografting for acute lymphoblastic leukemia in first or second complete remission.
Biol Blood Marrow Transplant. 2006 Apr; 12(4):438-53.BB

Abstract

We compared the outcomes of 298 patients with acute lymphoblastic leukemia in first or second complete remission (CR1 or CR2) receiving HLA-matched sibling allografts after cyclophosphamide and total body irradiation (Cy-TBI) conditioning with 204 patients receiving etoposide and TBI. Consequently, 4 groups were compared: Cy-TBI <13 Gy (n = 217), Cy-TBI > or =13 Gy (n = 81), etoposide-TBI <13 Gy (n = 53), and etoposide-TBI > or =13 Gy (n = 151). Analyses of relapse, leukemia-free survival (LFS), and survival were performed separately for CR1 and CR2 transplantations. Transplant-related mortality did not differ by conditioning regimen. In CR1, there were also no significant differences in relapse, LFS, or survival by conditioning regimen. In CR2, these outcomes differed among conditioning groups. In comparison with Cy-TBI <13 Gy, the risks of relapse, treatment failure (inverse of LFS), and mortality tended to be lower with etoposide (regardless of TBI dose) or with TBI doses > or =13 Gy. For both CR1 and CR2 transplantations, causes of death were similar among the groups; disease recurrence accounted for 47% of deaths. We conclude that for HLA-identical sibling allografts for acute lymphoblastic leukemia in CR2, there is an advantage in substituting etoposide for Cy or, when Cy is used, in increasing the TBI dose to > or =13 Gy.

Authors+Show Affiliations

Adult BMT Unit, Bristol Children's Hospital, Bristol, UK.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16545728

Citation

Marks, David I., et al. "A Comparison of Cyclophosphamide and Total Body Irradiation With Etoposide and Total Body Irradiation as Conditioning Regimens for Patients Undergoing Sibling Allografting for Acute Lymphoblastic Leukemia in First or Second Complete Remission." Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation, vol. 12, no. 4, 2006, pp. 438-53.
Marks DI, Forman SJ, Blume KG, et al. A comparison of cyclophosphamide and total body irradiation with etoposide and total body irradiation as conditioning regimens for patients undergoing sibling allografting for acute lymphoblastic leukemia in first or second complete remission. Biol Blood Marrow Transplant. 2006;12(4):438-53.
Marks, D. I., Forman, S. J., Blume, K. G., Pérez, W. S., Weisdorf, D. J., Keating, A., Gale, R. P., Cairo, M. S., Copelan, E. A., Horan, J. T., Lazarus, H. M., Litzow, M. R., McCarthy, P. L., Schultz, K. R., Smith, D. D., Trigg, M. E., Zhang, M. J., & Horowitz, M. M. (2006). A comparison of cyclophosphamide and total body irradiation with etoposide and total body irradiation as conditioning regimens for patients undergoing sibling allografting for acute lymphoblastic leukemia in first or second complete remission. Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation, 12(4), 438-53.
Marks DI, et al. A Comparison of Cyclophosphamide and Total Body Irradiation With Etoposide and Total Body Irradiation as Conditioning Regimens for Patients Undergoing Sibling Allografting for Acute Lymphoblastic Leukemia in First or Second Complete Remission. Biol Blood Marrow Transplant. 2006;12(4):438-53. PubMed PMID: 16545728.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A comparison of cyclophosphamide and total body irradiation with etoposide and total body irradiation as conditioning regimens for patients undergoing sibling allografting for acute lymphoblastic leukemia in first or second complete remission. AU - Marks,David I, AU - Forman,Stephen J, AU - Blume,Karl G, AU - Pérez,Waleska S, AU - Weisdorf,Daniel J, AU - Keating,Armand, AU - Gale,Robert Peter, AU - Cairo,Mitchell S, AU - Copelan,Edward A, AU - Horan,John T, AU - Lazarus,Hillard M, AU - Litzow,Mark R, AU - McCarthy,Philip L, AU - Schultz,Kirk R, AU - Smith,David D, AU - Trigg,Michael E, AU - Zhang,Mei-Jie, AU - Horowitz,Mary M, PY - 2005/08/03/received PY - 2005/12/05/accepted PY - 2006/3/21/pubmed PY - 2006/12/23/medline PY - 2006/3/21/entrez SP - 438 EP - 53 JF - Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation JO - Biol Blood Marrow Transplant VL - 12 IS - 4 N2 - We compared the outcomes of 298 patients with acute lymphoblastic leukemia in first or second complete remission (CR1 or CR2) receiving HLA-matched sibling allografts after cyclophosphamide and total body irradiation (Cy-TBI) conditioning with 204 patients receiving etoposide and TBI. Consequently, 4 groups were compared: Cy-TBI <13 Gy (n = 217), Cy-TBI > or =13 Gy (n = 81), etoposide-TBI <13 Gy (n = 53), and etoposide-TBI > or =13 Gy (n = 151). Analyses of relapse, leukemia-free survival (LFS), and survival were performed separately for CR1 and CR2 transplantations. Transplant-related mortality did not differ by conditioning regimen. In CR1, there were also no significant differences in relapse, LFS, or survival by conditioning regimen. In CR2, these outcomes differed among conditioning groups. In comparison with Cy-TBI <13 Gy, the risks of relapse, treatment failure (inverse of LFS), and mortality tended to be lower with etoposide (regardless of TBI dose) or with TBI doses > or =13 Gy. For both CR1 and CR2 transplantations, causes of death were similar among the groups; disease recurrence accounted for 47% of deaths. We conclude that for HLA-identical sibling allografts for acute lymphoblastic leukemia in CR2, there is an advantage in substituting etoposide for Cy or, when Cy is used, in increasing the TBI dose to > or =13 Gy. SN - 1083-8791 UR - https://www.unboundmedicine.com/medline/citation/16545728/A_comparison_of_cyclophosphamide_and_total_body_irradiation_with_etoposide_and_total_body_irradiation_as_conditioning_regimens_for_patients_undergoing_sibling_allografting_for_acute_lymphoblastic_leukemia_in_first_or_second_complete_remission_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1083-8791(05)01410-2 DB - PRIME DP - Unbound Medicine ER -