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Once-a-day fractionated total-body irradiation: A regimen tailored to local logistics in allogeneic stem cell transplantation for acute lymphoblastic leukemia.
Rep Pract Oncol Radiother. 2020 May-Jun; 25(3):436-441.RP

Abstract

Aim

The objective of the study was to estimate the cumulative incidence (CI) of relapse, relapse-free survival (RFS) and overall survival (OS) in ALL patients after a once-a-day fractionated TBI (F-TBI) regimen with 9.9 Gy. The secondary objectives were evaluation of short and long-term toxicity and non-relapse mortality (NRM).

Background

Total body irradiation (TBI), as a part of the conditioning regimen before allogeneic stem cell transplantation (ASCT) for acute lymphoblastic leukemia (ALL), allows disease control by eradicating residual blast cells in the transplant recipient.

Materials and methods

Retrospective study conducted in patients with ALL who received between March 2003 and December 2013 a conditioning regimen with F-TBI and chemotherapy. Irradiation was delivered with 3.3 Gy once-a-day for three consecutive days.

Results

Eighty-seven patients were included. The median age was 19 years (range: 5-49 years). The 3-year CI of relapse was 30%. The estimated 3-year RFS and OS were 54% and 58%, respectively. Cumulative incidence of acute graft-versus-host disease (aGVHD) grade II-IV and chronic GVHD (cGVHD) was 31% and 40%, respectively. Interstitial pneumonitis was observed in 2 patients. The 3-year CI of NRM was 16%. In multivariate analysis, cGVHD was associated with a lower CI of relapse (RR = 0.26, 95% CI: 0.07-0.95, p = 0.04). High-risk cytogenetics was associated with a lower RFS (RR = 2, 95 CI: 1.04-3.84, p = 0.03). Grade II-IV aGVHD was an independent predictor of higher CI of NRM (RR = 6.7, 95% CI: 1.4-31.7, p = 0.02).

Conclusions

Once-a-day F-TBI regimen is effective, safe and practical in patients who underwent ASCT for ALL.

Authors+Show Affiliations

Centre National de Greffe de Moelle Osseuse, Tunis, Tunisia.Centre National de Greffe de Moelle Osseuse, Tunis, Tunisia.Centre National de Greffe de Moelle Osseuse, Tunis, Tunisia.Service de Radiothérapie, Institut Salah Azaiz, Tunis, Tunisia.Centre National de Greffe de Moelle Osseuse, Tunis, Tunisia.Centre National de Greffe de Moelle Osseuse, Tunis, Tunisia.Centre National de Greffe de Moelle Osseuse, Tunis, Tunisia.Centre National de Greffe de Moelle Osseuse, Tunis, Tunisia.Service de Radiothérapie, Institut Salah Azaiz, Tunis, Tunisia.Service de Radiothérapie, Institut Salah Azaiz, Tunis, Tunisia.Service de Radiothérapie, Institut Salah Azaiz, Tunis, Tunisia.Centre National de Greffe de Moelle Osseuse, Tunis, Tunisia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32372884

Citation

Ben Abdeljelil, Nour, et al. "Once-a-day Fractionated Total-body Irradiation: a Regimen Tailored to Local Logistics in Allogeneic Stem Cell Transplantation for Acute Lymphoblastic Leukemia." Reports of Practical Oncology and Radiotherapy : Journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology, vol. 25, no. 3, 2020, pp. 436-441.
Ben Abdeljelil N, Ladeb S, Dahmani T, et al. Once-a-day fractionated total-body irradiation: A regimen tailored to local logistics in allogeneic stem cell transplantation for acute lymphoblastic leukemia. Rep Pract Oncol Radiother. 2020;25(3):436-441.
Ben Abdeljelil, N., Ladeb, S., Dahmani, T., Kochbati, L., Lakhal, A., El Fatmi, R., Torjemane, L., Belloumi, D., Besbes, M., El Benna, F., Nasr Ben Ammar, C., & Ben Othman, T. (2020). Once-a-day fractionated total-body irradiation: A regimen tailored to local logistics in allogeneic stem cell transplantation for acute lymphoblastic leukemia. Reports of Practical Oncology and Radiotherapy : Journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology, 25(3), 436-441. https://doi.org/10.1016/j.rpor.2020.03.023
Ben Abdeljelil N, et al. Once-a-day Fractionated Total-body Irradiation: a Regimen Tailored to Local Logistics in Allogeneic Stem Cell Transplantation for Acute Lymphoblastic Leukemia. Rep Pract Oncol Radiother. 2020 May-Jun;25(3):436-441. PubMed PMID: 32372884.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Once-a-day fractionated total-body irradiation: A regimen tailored to local logistics in allogeneic stem cell transplantation for acute lymphoblastic leukemia. AU - Ben Abdeljelil,Nour, AU - Ladeb,Saloua, AU - Dahmani,Talel, AU - Kochbati,Lotfi, AU - Lakhal,Amel, AU - El Fatmi,Rym, AU - Torjemane,Lamia, AU - Belloumi,Dorra, AU - Besbes,Mounir, AU - El Benna,Farouk, AU - Nasr Ben Ammar,Chiraz, AU - Ben Othman,Tarek, Y1 - 2020/04/28/ PY - 2018/09/14/received PY - 2020/03/20/accepted PY - 2021/05/01/pmc-release PY - 2020/5/7/entrez PY - 2020/5/7/pubmed PY - 2020/5/7/medline SP - 436 EP - 441 JF - Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology JO - Rep Pract Oncol Radiother VL - 25 IS - 3 N2 - Aim: The objective of the study was to estimate the cumulative incidence (CI) of relapse, relapse-free survival (RFS) and overall survival (OS) in ALL patients after a once-a-day fractionated TBI (F-TBI) regimen with 9.9 Gy. The secondary objectives were evaluation of short and long-term toxicity and non-relapse mortality (NRM). Background: Total body irradiation (TBI), as a part of the conditioning regimen before allogeneic stem cell transplantation (ASCT) for acute lymphoblastic leukemia (ALL), allows disease control by eradicating residual blast cells in the transplant recipient. Materials and methods: Retrospective study conducted in patients with ALL who received between March 2003 and December 2013 a conditioning regimen with F-TBI and chemotherapy. Irradiation was delivered with 3.3 Gy once-a-day for three consecutive days. Results: Eighty-seven patients were included. The median age was 19 years (range: 5-49 years). The 3-year CI of relapse was 30%. The estimated 3-year RFS and OS were 54% and 58%, respectively. Cumulative incidence of acute graft-versus-host disease (aGVHD) grade II-IV and chronic GVHD (cGVHD) was 31% and 40%, respectively. Interstitial pneumonitis was observed in 2 patients. The 3-year CI of NRM was 16%. In multivariate analysis, cGVHD was associated with a lower CI of relapse (RR = 0.26, 95% CI: 0.07-0.95, p = 0.04). High-risk cytogenetics was associated with a lower RFS (RR = 2, 95 CI: 1.04-3.84, p = 0.03). Grade II-IV aGVHD was an independent predictor of higher CI of NRM (RR = 6.7, 95% CI: 1.4-31.7, p = 0.02). Conclusions: Once-a-day F-TBI regimen is effective, safe and practical in patients who underwent ASCT for ALL. SN - 1507-1367 UR - https://www.unboundmedicine.com/medline/citation/32372884/Once-a-day_fractionated_total-body_irradiation:_A_regimen_tailored_to_local_logistics_in_allogeneic_stem_cell_transplantation_for_acute_lymphoblastic_leukemia L2 - https://linkinghub.elsevier.com/retrieve/pii/S1507-1367(20)30052-3 DB - PRIME DP - Unbound Medicine ER -
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