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- Thiotepa-Based Regimens Are Valid Alternatives to Total Body Irradiation-Based Reduced-Intensity Conditioning Regimens in Patients with Acute Lymphoblastic Leukemia: A Retrospective Study on Behalf of the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation.
Thiotepa-Based Regimens Are Valid Alternatives to Total Body Irradiation-Based Reduced-Intensity Conditioning Regimens in Patients with Acute Lymphoblastic Leukemia: A Retrospective Study on Behalf of the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation.
Fecha de publicación:
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Autores de IIS La Fe
Participantes ajenos a IIS La Fe
- Battipaglia G
- Labopin M
- Mielke S
- Ruggeri A
- Nur Ozkurt Z
- Bourhis JH
- Rabitsch W
- Yakoub-Agha I
- Grillo G
- Arcese W
- Novis Y
- Fegueux N
- Spyridonidis A
- Giebel S
- Nagler A
- Ciceri F
- Mohty M
Grupos
Abstract
Total body irradiation (TBI) at myeloablative doses is superior to chemotherapy-based regimens in young patients with acute lymphoblastic leukemia (ALL) undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT). However, in elderly and unfit patients, in whom reduced-intensity conditioning (RIC) regimens are preferred, whether a TBI-based or a chemotherapy-based approach is better is unexplored. Thiotepa can be used as part of ALL conditioning regimens. The current study aimed to compare transplantation outcomes after RIC with TBI-based or thiotepa-based regimens in patients with ALL. The study cohort comprised patients aged =40 years undergoing allo-HSCT for ALL in first complete remission between 2000 and 2020 who received an RIC regimen containing either TBI (4 to 6 Gy) or thiotepa. We identified a total of 265 patients, including 117 who received a TBI-based RIC regimen and 148 who received a thiotepa-based RIC regimen. Univariate analysis revealed no significant differences in the following transplantation outcomes for TBI versus thiotepa: relapse, 23% versus 28% (P = .24); nonrelapse mortality, 20% versus 26% (P = .61); leukemia-free survival, 57% versus 46% (P = .12); overall survival, 67% versus 56% (P = .18); graft-versus-host disease (GVHD]/relapse-free survival, 45% versus 38% (P = .21); grade II-IV acute GVHD, 30% in both groups (P = .84); grade III-IV acute GVHD, 9% versus 10% (P = .89). The sole exception was the incidence of chronic GVHD, which was higher in the recipients of TBI-based regimens (43% versus 29%; P = .03). However, multivariate analysis revealed no differences in transplantation outcomes between the 2 groups. In patients aged =40 years receiving RIC, use of a thiotepa-based regimen may represent a valid alternative to TBI-based regimens, as no differences were observed in the main transplantation outcomes.
Copyright © 2023 The American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc. All rights reserved.
Datos de la publicación
- ISSN/ISSNe:
- 2666-6375, 2666-6367
- Tipo:
- Article
- Páginas:
- -
- PubMed:
- 37816471
Transplantation And Cellular Therapy ELSEVIER SCIENCE INC
Citas Recibidas en Web of Science: 9
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Filiaciones
Keywords
- Acute lymphoblastic leukemia; Thiotepa; Total body irradiation; Transplantation
Cita
Battipaglia G,Labopin M,Mielke S,Ruggeri A,Nur Z,Bourhis JH,Rabitsch W,Yakoub I,Grillo G,SANZ J,Arcese W,Novis Y,Fegueux N,Spyridonidis A,Giebel S,Nagler A,Ciceri F,Mohty M. Thiotepa-Based Regimens Are Valid Alternatives to Total Body Irradiation-Based Reduced-Intensity Conditioning Regimens in Patients with Acute Lymphoblastic Leukemia: A Retrospective Study on Behalf of the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation. Transpl. Cell. Ther. 2024. 30. (1):95.e1-95.e10. IF:4,400. (1).