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http://dx.doi.org/10.3345/kjp.2010.53.4.538

Comparison of total body irradiation-based or non-total body irradiation-based conditioning regimens for allogeneic stem cell transplantation in pediatric leukemia patients  

Kim, Sang-Jeong (Department of Pediatrics, Chonnam National University Hwasun Hospital Chonnam National University Medical School)
Han, Dong-Kyun (Department of Pediatrics, Chonnam National University Hwasun Hospital Chonnam National University Medical School)
Baek, Hee-Jo (Department of Pediatrics, Chonnam National University Hwasun Hospital Chonnam National University Medical School)
Kim, Dong-Yeon (Department of Pediatrics, Chonnam National University Hwasun Hospital Chonnam National University Medical School)
Nam, Taek-Keun (Department of Radiation Oncology, Chonnam National University Hwasun Hospital Chonnam National University Medical School)
Hwang, Tai-Ju (Department of Pediatrics, Chonnam National University Hwasun Hospital Chonnam National University Medical School)
Kook, Hoon (Department of Pediatrics, Chonnam National University Hwasun Hospital Chonnam National University Medical School)
Publication Information
Clinical and Experimental Pediatrics / v.53, no.4, 2010 , pp. 538-547 More about this Journal
Abstract
Purpose : This study aims to compare the outcome of total body irradiation (TBI)- or non-TBI-containing conditioning regimens for leukemia in children. Methods : We retrospectively evaluated 77 children conditioned with TBI (n=40) or non-TBI (n=37) regimens, transplanted at Chonnam National University Hospital between January 1996 and December 2007. The type of transplantation, disease status at the time of transplant, conditioning regimen, engraftment kinetics, development of graft-versus-host disease (GVHD), complications, cause of deaths, overall survival (OS), and event-free survival (EFS) were compared between the 2 groups. Results : Among 34 patients with acute lymphoblastic leukemia (ALL), 28 (82.4%) were in the TBI group, while 72.7% (24/33) of patients with myeloid leukemia were in the non-TBI group. Although the 5-year EFS of the 2 groups was similar for all patients (62% vs 63%), the TBI group showed a better 5-year EFS than the non-TBI group when only ALL patients were analyzed (65% vs 17%; $P$=0.005). In acute myelogenous leukemia patients, the non-TBI group had better survival tendency (73% vs 38%; $P$=0.089). The incidence of GVHD, engraftment, survival, cause of death, and late complications was not different between the 2 groups. Conclusion : The TBI and non-TBI groups showed comparable results, but the TBI group showed a significantly higher 5-year EFS than the non-TBI group in ALL patients. Further prospective, randomized controlled studies involving larger number of patients are needed to assess the late-onset complications and to compare the socioeconomic quality of life.
Keywords
Transplantation conditioning; Leukemia; Hematopoietic stem cell; Child;
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