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Late effects of allogeneic bone marrow transplantation for children with acute myeloblastic leukemia in first complete remission: the impact of conditioning regimen without total-body irradiation--a report from the Société Française de Greffe de Moelle.
J Clin Oncol. 1997 Jun; 15(6):2238-46.JC

Abstract

PURPOSE

To evaluate growth, thyroid function, puberty, cardiac function, and the incidence of cataracts in children who received allogeneic bone marrow transplantation (BMT) for acute myeloblastic leukemia (AML) in first complete remission (CR) after a preparation with or without total-body irradiation (TBI).

PATIENTS AND METHODS

Among 45 children studied, 26 received busulfan-cyclophosphamide (Bu-Cy) in preparation for transplantation and 19 received TBI. TBI was fractionated in nine cases and delivered as a single dose in 10. Four children in the Bu-Cy group and none in the TBI group had received prior cranial radiation. The mean follow-up duration after BMT was 5.9 years for the whole group.

RESULTS

The mean cumulative changes in height SD score (SDS) were -0.86 at 3 years and -1.56 at 5 years in the TBI group, whereas these changes were only -0.05 and -0.17 in the Bu-Cy group (P < .01 at 3 and 5 years). The 6-year probability of hypothyroidism was 9% +/- 8% in the Bu-Cy group and 43% +/- 15% after TBI (P < .02). Pubertal development after Bu-Cy was assessable in two girls and five boys: both girls had primary ovarian failure, whereas Leydig cell function appeared to be preserved in the five boys. One child who had received anthracycline when he was less than 1 year old developed cardiac dysfunction 4 years after Bu-Cy. The 6-year probability of cataracts was 70% +/- 13% in the TBI group and 0% after Bu-Cy.

CONCLUSION

The use of Bu-Cy represents an alternative transplant cytoreductive regimen for children with AML in first CR, which can reduce the risk of posttransplant growth impairment, thyroid dysfunction, Leydig cell damage, and the incidence of cataracts.

Authors+Show Affiliations

Hôpital d'Enfants La Timone and the Institut Paoli-Calmettes, Marseille, France. gmichel@ap_hm.frNo 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
Journal Article
Multicenter Study

Language

eng

PubMed ID

9196136

Citation

Michel, G, et al. "Late Effects of Allogeneic Bone Marrow Transplantation for Children With Acute Myeloblastic Leukemia in First Complete Remission: the Impact of Conditioning Regimen Without Total-body Irradiation--a Report From the Société Française De Greffe De Moelle." Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, vol. 15, no. 6, 1997, pp. 2238-46.
Michel G, Socié G, Gebhard F, et al. Late effects of allogeneic bone marrow transplantation for children with acute myeloblastic leukemia in first complete remission: the impact of conditioning regimen without total-body irradiation--a report from the Société Française de Greffe de Moelle. J Clin Oncol. 1997;15(6):2238-46.
Michel, G., Socié, G., Gebhard, F., Bernaudin, F., Thuret, I., Vannier, J. P., Demeocq, F., Leverger, G., Pico, J. L., Rubie, H., Mechinaud, F., Reiffers, J., Gratecos, N., Troussard, X., Jouet, J. P., Simonin, G., Gluckman, E., & Maraninchi, D. (1997). Late effects of allogeneic bone marrow transplantation for children with acute myeloblastic leukemia in first complete remission: the impact of conditioning regimen without total-body irradiation--a report from the Société Française de Greffe de Moelle. Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, 15(6), 2238-46.
Michel G, et al. Late Effects of Allogeneic Bone Marrow Transplantation for Children With Acute Myeloblastic Leukemia in First Complete Remission: the Impact of Conditioning Regimen Without Total-body Irradiation--a Report From the Société Française De Greffe De Moelle. J Clin Oncol. 1997;15(6):2238-46. PubMed PMID: 9196136.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Late effects of allogeneic bone marrow transplantation for children with acute myeloblastic leukemia in first complete remission: the impact of conditioning regimen without total-body irradiation--a report from the Société Française de Greffe de Moelle. AU - Michel,G, AU - Socié,G, AU - Gebhard,F, AU - Bernaudin,F, AU - Thuret,I, AU - Vannier,J P, AU - Demeocq,F, AU - Leverger,G, AU - Pico,J L, AU - Rubie,H, AU - Mechinaud,F, AU - Reiffers,J, AU - Gratecos,N, AU - Troussard,X, AU - Jouet,J P, AU - Simonin,G, AU - Gluckman,E, AU - Maraninchi,D, PY - 1997/6/1/pubmed PY - 1997/6/1/medline PY - 1997/6/1/entrez SP - 2238 EP - 46 JF - Journal of clinical oncology : official journal of the American Society of Clinical Oncology JO - J Clin Oncol VL - 15 IS - 6 N2 - PURPOSE: To evaluate growth, thyroid function, puberty, cardiac function, and the incidence of cataracts in children who received allogeneic bone marrow transplantation (BMT) for acute myeloblastic leukemia (AML) in first complete remission (CR) after a preparation with or without total-body irradiation (TBI). PATIENTS AND METHODS: Among 45 children studied, 26 received busulfan-cyclophosphamide (Bu-Cy) in preparation for transplantation and 19 received TBI. TBI was fractionated in nine cases and delivered as a single dose in 10. Four children in the Bu-Cy group and none in the TBI group had received prior cranial radiation. The mean follow-up duration after BMT was 5.9 years for the whole group. RESULTS: The mean cumulative changes in height SD score (SDS) were -0.86 at 3 years and -1.56 at 5 years in the TBI group, whereas these changes were only -0.05 and -0.17 in the Bu-Cy group (P < .01 at 3 and 5 years). The 6-year probability of hypothyroidism was 9% +/- 8% in the Bu-Cy group and 43% +/- 15% after TBI (P < .02). Pubertal development after Bu-Cy was assessable in two girls and five boys: both girls had primary ovarian failure, whereas Leydig cell function appeared to be preserved in the five boys. One child who had received anthracycline when he was less than 1 year old developed cardiac dysfunction 4 years after Bu-Cy. The 6-year probability of cataracts was 70% +/- 13% in the TBI group and 0% after Bu-Cy. CONCLUSION: The use of Bu-Cy represents an alternative transplant cytoreductive regimen for children with AML in first CR, which can reduce the risk of posttransplant growth impairment, thyroid dysfunction, Leydig cell damage, and the incidence of cataracts. SN - 0732-183X UR - https://www.unboundmedicine.com/medline/citation/9196136/Late_effects_of_allogeneic_bone_marrow_transplantation_for_children_with_acute_myeloblastic_leukemia_in_first_complete_remission:_the_impact_of_conditioning_regimen_without_total_body_irradiation__a_report_from_the_Société_Française_de_Greffe_de_Moelle_ L2 - https://ascopubs.org/doi/10.1200/JCO.1997.15.6.2238?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -