Tags

Type your tag names separated by a space and hit enter

Comparison of Outcomes for Pediatric Patients With Acute Myeloid Leukemia in Remission and Undergoing Allogeneic Hematopoietic Cell Transplantation With Myeloablative Conditioning Regimens Based on Either Intravenous Busulfan or Total Body Irradiation: A Report From the Japanese Society for Hematopoietic Cell Transplantation.
Biol Blood Marrow Transplant. 2015 Dec; 21(12):2141-2147.BB

Abstract

Pediatric patients with acute myeloid leukemia (AML) mainly receive myeloablative conditioning regimens based on busulfan (BU) or total body irradiation (TBI) before allogeneic hematopoietic cell transplantation (allo-HCT); however, the optimal conditioning regimen remains unclear. To identify which of these regimens is better for pediatric patients, we performed a retrospective analysis of nationwide registration data collected in Japan between 2006 and 2011 to assess the outcomes of patients receiving these regimens before a first allo-HCT. Myeloablative conditioning regimens based on i.v. BU (i.v. BU-MAC) (n = 69) or TBI (TBI-MAC) (n = 151) were compared in pediatric AML patients in first or second complete remission (CR1/CR2). The incidences of sinusoid obstruction syndrome, acute and chronic graft-versus-host disease, and early nonrelapse mortality (NRM) before day 100 were similar for both conditioning groups; however, the incidence of bacterial infection during the acute period was higher in the TBI-MAC group (P = .008). Both groups showed a similar incidence of NRM, and there was no significant difference in the incidence of relapse between the groups. Univariate and multivariate analyses revealed no significant differences in the 2-year relapse-free survival rates for the i.v. BU-MAC and TBI-MAC groups in the CR1/CR2 setting (71% versus 67%, P = .36; hazard ratio, .73; 95% CI, .43 to 1.24, respectively). TBI-MAC was no better than i.v. BU-MAC for pediatric AML patients in remission. Although this retrospective registry-based analysis has several limitations, i.v. BU-MAC warrants further evaluation in a prospective trial.

Authors+Show Affiliations

Department of Pediatrics and Blood and Marrow Transplantation, Matsushita Memorial Hospital, Moriguchi, Japan; Department of Pediatrics, Kyoto Prefectural University of Medicine, Kyoto, Japan. Electronic address: ishidah@koto.kpu-m.ac.jp.Department of Pediatrics and Cell Therapy and Transplantation Medicine, University of Tokyo, Tokyo, Japan.Department of Pediatrics, Fujita Health University School of Medicine, Aichi, Japan.Department of Pediatrics, Shiga University, Graduate School of Medicine, Otsu, Japan.Division of Leukemia and Lymphoma, Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan.Department of Pediatrics, Osaka University, Graduate School of Medicine, Suita, Japan.Devision of Hemato-Oncology/Regenerative Medicine, Kanagawa Children's Medical Center, Yokohama, Japan.Department of Pediatrics, National Kyushu Cancer Center, Fukuoka, Japan.Department of Hematology/Oncology, Saitama Children's Medical Center, Saitama, Japan.Department of Pediatrics, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.Department of Pediatrics, Niigata Cancer Center Hospital, Niigata, Japan.Department of Pediatrics, Kagoshima University Medical and Dental Hospital, Kagoshima, Japan.Department of Hematology/Oncology, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan.Department of Hematology/Oncology, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan.Department of Hematology/Oncology, Children's Medical Center, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan.Japanese Data Center for Hematopoietic Cell Transplantation and Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.Department of Hematopoietic Stem Cell Transplantation, National Cancer Center, Tokyo, Japan.Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26271192

Citation

Ishida, Hiroyuki, et al. "Comparison of Outcomes for Pediatric Patients With Acute Myeloid Leukemia in Remission and Undergoing Allogeneic Hematopoietic Cell Transplantation With Myeloablative Conditioning Regimens Based On Either Intravenous Busulfan or Total Body Irradiation: a Report From the Japanese Society for Hematopoietic Cell Transplantation." Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation, vol. 21, no. 12, 2015, pp. 2141-2147.
Ishida H, Kato M, Kudo K, et al. Comparison of Outcomes for Pediatric Patients With Acute Myeloid Leukemia in Remission and Undergoing Allogeneic Hematopoietic Cell Transplantation With Myeloablative Conditioning Regimens Based on Either Intravenous Busulfan or Total Body Irradiation: A Report From the Japanese Society for Hematopoietic Cell Transplantation. Biol Blood Marrow Transplant. 2015;21(12):2141-2147.
Ishida, H., Kato, M., Kudo, K., Taga, T., Tomizawa, D., Miyamura, T., Goto, H., Inagaki, J., Koh, K., Terui, K., Ogawa, A., Kawano, Y., Inoue, M., Sawada, A., Kato, K., Atsuta, Y., Yamashita, T., & Adachi, S. (2015). Comparison of Outcomes for Pediatric Patients With Acute Myeloid Leukemia in Remission and Undergoing Allogeneic Hematopoietic Cell Transplantation With Myeloablative Conditioning Regimens Based on Either Intravenous Busulfan or Total Body Irradiation: A Report From the Japanese Society for Hematopoietic Cell Transplantation. Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation, 21(12), 2141-2147. https://doi.org/10.1016/j.bbmt.2015.08.011
Ishida H, et al. Comparison of Outcomes for Pediatric Patients With Acute Myeloid Leukemia in Remission and Undergoing Allogeneic Hematopoietic Cell Transplantation With Myeloablative Conditioning Regimens Based On Either Intravenous Busulfan or Total Body Irradiation: a Report From the Japanese Society for Hematopoietic Cell Transplantation. Biol Blood Marrow Transplant. 2015;21(12):2141-2147. PubMed PMID: 26271192.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of Outcomes for Pediatric Patients With Acute Myeloid Leukemia in Remission and Undergoing Allogeneic Hematopoietic Cell Transplantation With Myeloablative Conditioning Regimens Based on Either Intravenous Busulfan or Total Body Irradiation: A Report From the Japanese Society for Hematopoietic Cell Transplantation. AU - Ishida,Hiroyuki, AU - Kato,Motohiro, AU - Kudo,Kazuko, AU - Taga,Takashi, AU - Tomizawa,Daisuke, AU - Miyamura,Takako, AU - Goto,Hiroaki, AU - Inagaki,Jiro, AU - Koh,Katsuyoshi, AU - Terui,Kiminori, AU - Ogawa,Atsushi, AU - Kawano,Yoshifumi, AU - Inoue,Masami, AU - Sawada,Akihisa, AU - Kato,Koji, AU - Atsuta,Yoshiko, AU - Yamashita,Takuya, AU - Adachi,Souichi, Y1 - 2015/08/10/ PY - 2015/04/25/received PY - 2015/08/06/accepted PY - 2015/8/15/entrez PY - 2015/8/15/pubmed PY - 2016/8/18/medline KW - Acute myeloid leukemia KW - Busulfan KW - Children KW - Hematopoietic stem cell transplantation KW - Total body irradiation SP - 2141 EP - 2147 JF - Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation JO - Biol Blood Marrow Transplant VL - 21 IS - 12 N2 - Pediatric patients with acute myeloid leukemia (AML) mainly receive myeloablative conditioning regimens based on busulfan (BU) or total body irradiation (TBI) before allogeneic hematopoietic cell transplantation (allo-HCT); however, the optimal conditioning regimen remains unclear. To identify which of these regimens is better for pediatric patients, we performed a retrospective analysis of nationwide registration data collected in Japan between 2006 and 2011 to assess the outcomes of patients receiving these regimens before a first allo-HCT. Myeloablative conditioning regimens based on i.v. BU (i.v. BU-MAC) (n = 69) or TBI (TBI-MAC) (n = 151) were compared in pediatric AML patients in first or second complete remission (CR1/CR2). The incidences of sinusoid obstruction syndrome, acute and chronic graft-versus-host disease, and early nonrelapse mortality (NRM) before day 100 were similar for both conditioning groups; however, the incidence of bacterial infection during the acute period was higher in the TBI-MAC group (P = .008). Both groups showed a similar incidence of NRM, and there was no significant difference in the incidence of relapse between the groups. Univariate and multivariate analyses revealed no significant differences in the 2-year relapse-free survival rates for the i.v. BU-MAC and TBI-MAC groups in the CR1/CR2 setting (71% versus 67%, P = .36; hazard ratio, .73; 95% CI, .43 to 1.24, respectively). TBI-MAC was no better than i.v. BU-MAC for pediatric AML patients in remission. Although this retrospective registry-based analysis has several limitations, i.v. BU-MAC warrants further evaluation in a prospective trial. SN - 1523-6536 UR - https://www.unboundmedicine.com/medline/citation/26271192/Comparison_of_Outcomes_for_Pediatric_Patients_With_Acute_Myeloid_Leukemia_in_Remission_and_Undergoing_Allogeneic_Hematopoietic_Cell_Transplantation_With_Myeloablative_Conditioning_Regimens_Based_on_Either_Intravenous_Busulfan_or_Total_Body_Irradiation:_A_Report_From_the_Japanese_Society_for_Hematopoietic_Cell_Transplantation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1083-8791(15)00540-6 DB - PRIME DP - Unbound Medicine ER -