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Excellent outcome of allogeneic hematopoietic stem cell transplantation using a conditioning regimen with medium-dose VP-16, cyclophosphamide and total-body irradiation for adult patients with acute lymphoblastic leukemia.
Biol Blood Marrow Transplant. 2008 May; 14(5):568-75.BB

Abstract

We retrospectively evaluated the outcomes of 37 adult patients with acute lymphoblastic leukemia (ALL) undergoing allogeneic hematopoietic stem cell transplantation (allo-SCT) conditioned with medium-dose VP-16 (VP, 30 mg/kg), cyclophosphamide (CY, 120 mg/kg), and fractionated total-body irradiation (TBI, 12 Gy) (medium-dose VP/CY/TBI). The median age of the patients was 26 years. Thirteen patients underwent transplantation from HLA-matched related donors (MRD), 18 patients underwent transplantation from HLA-matched unrelated donors (MUD), and 6 patients underwent transplantation from HLA-mismatched donors (MMD). Thirty-two patients received bone marrow and 4 patients received peripheral blood stem cells. Ten patients were Philadelphia chromosome-positive (Ph(+)) and 35 patients were in complete remission (CR) at transplantation. All of the patients achieved engraftment, and grade 3 organ toxicity before engraftment occurred in 27 patients. Grade II-III acute graft-versus-host disease (GVHD) and chronic GVHD (cGVHD) occurred in 15 and 18 patients, respectively. No patient developed grade IV acute GVHD (aGVHD) or died of GVHD. At median follow-up of 35.1 months, 32 patients were alive and all Ph(+) patients were alive. Three patients died of relapse and 2 died of transplant-related mortality (TRM). The actuarial 3-year overall survival (OS) rate, relapse rate, and TRM rate were 89.2%, 8.1%, and 5.4%, respectively. Non-CR at transplantation, MRD, and no aGVHD were significant adverse prognostic factors for survival. Medium-dose VP/CY/TBI for adult ALL patients was associated with lower relapse rate and no increase in toxicity, resulting in better survival.

Authors+Show Affiliations

Department of Hematology and Oncology, Hokkaido University Graduate School of Medicine, Sapporo, Japan. shigemap@r9.dion.ne.jpNo 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 availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18410899

Citation

Shigematsu, Akio, et al. "Excellent Outcome of Allogeneic Hematopoietic Stem Cell Transplantation Using a Conditioning Regimen With Medium-dose VP-16, Cyclophosphamide and Total-body Irradiation for Adult Patients With Acute Lymphoblastic Leukemia." Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation, vol. 14, no. 5, 2008, pp. 568-75.
Shigematsu A, Kondo T, Yamamoto S, et al. Excellent outcome of allogeneic hematopoietic stem cell transplantation using a conditioning regimen with medium-dose VP-16, cyclophosphamide and total-body irradiation for adult patients with acute lymphoblastic leukemia. Biol Blood Marrow Transplant. 2008;14(5):568-75.
Shigematsu, A., Kondo, T., Yamamoto, S., Sugita, J., Onozawa, M., Kahata, K., Endo, T., Shiratori, S., Ota, S., Obara, M., Wakasa, K., Takahata, M., Takeda, Y., Tanaka, J., Hashino, S., Nishio, M., Koike, T., Asaka, M., & Imamura, M. (2008). Excellent outcome of allogeneic hematopoietic stem cell transplantation using a conditioning regimen with medium-dose VP-16, cyclophosphamide and total-body irradiation for adult patients with acute lymphoblastic leukemia. Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation, 14(5), 568-75. https://doi.org/10.1016/j.bbmt.2008.02.018
Shigematsu A, et al. Excellent Outcome of Allogeneic Hematopoietic Stem Cell Transplantation Using a Conditioning Regimen With Medium-dose VP-16, Cyclophosphamide and Total-body Irradiation for Adult Patients With Acute Lymphoblastic Leukemia. Biol Blood Marrow Transplant. 2008;14(5):568-75. PubMed PMID: 18410899.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Excellent outcome of allogeneic hematopoietic stem cell transplantation using a conditioning regimen with medium-dose VP-16, cyclophosphamide and total-body irradiation for adult patients with acute lymphoblastic leukemia. AU - Shigematsu,Akio, AU - Kondo,Takeshi, AU - Yamamoto,Satoshi, AU - Sugita,Junichi, AU - Onozawa,Masahiro, AU - Kahata,Kaoru, AU - Endo,Tomoyuki, AU - Shiratori,Soichi, AU - Ota,Shuichi, AU - Obara,Masato, AU - Wakasa,Kentaro, AU - Takahata,Mutsumi, AU - Takeda,Yukari, AU - Tanaka,Junji, AU - Hashino,Satoshi, AU - Nishio,Mitsufumi, AU - Koike,Takao, AU - Asaka,Masahiro, AU - Imamura,Masahiro, PY - 2008/01/08/received PY - 2008/02/26/accepted PY - 2008/4/16/pubmed PY - 2008/7/9/medline PY - 2008/4/16/entrez SP - 568 EP - 75 JF - Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation JO - Biol Blood Marrow Transplant VL - 14 IS - 5 N2 - We retrospectively evaluated the outcomes of 37 adult patients with acute lymphoblastic leukemia (ALL) undergoing allogeneic hematopoietic stem cell transplantation (allo-SCT) conditioned with medium-dose VP-16 (VP, 30 mg/kg), cyclophosphamide (CY, 120 mg/kg), and fractionated total-body irradiation (TBI, 12 Gy) (medium-dose VP/CY/TBI). The median age of the patients was 26 years. Thirteen patients underwent transplantation from HLA-matched related donors (MRD), 18 patients underwent transplantation from HLA-matched unrelated donors (MUD), and 6 patients underwent transplantation from HLA-mismatched donors (MMD). Thirty-two patients received bone marrow and 4 patients received peripheral blood stem cells. Ten patients were Philadelphia chromosome-positive (Ph(+)) and 35 patients were in complete remission (CR) at transplantation. All of the patients achieved engraftment, and grade 3 organ toxicity before engraftment occurred in 27 patients. Grade II-III acute graft-versus-host disease (GVHD) and chronic GVHD (cGVHD) occurred in 15 and 18 patients, respectively. No patient developed grade IV acute GVHD (aGVHD) or died of GVHD. At median follow-up of 35.1 months, 32 patients were alive and all Ph(+) patients were alive. Three patients died of relapse and 2 died of transplant-related mortality (TRM). The actuarial 3-year overall survival (OS) rate, relapse rate, and TRM rate were 89.2%, 8.1%, and 5.4%, respectively. Non-CR at transplantation, MRD, and no aGVHD were significant adverse prognostic factors for survival. Medium-dose VP/CY/TBI for adult ALL patients was associated with lower relapse rate and no increase in toxicity, resulting in better survival. SN - 1523-6536 UR - https://www.unboundmedicine.com/medline/citation/18410899/Excellent_outcome_of_allogeneic_hematopoietic_stem_cell_transplantation_using_a_conditioning_regimen_with_medium_dose_VP_16_cyclophosphamide_and_total_body_irradiation_for_adult_patients_with_acute_lymphoblastic_leukemia_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1083-8791(08)00107-9 DB - PRIME DP - Unbound Medicine ER -