Eichinger, Anna and Poetschger, Ulrike and Glogova, Evgenia and Bader, Peter and Basu, Oliver and Beier, Rita and Burkhardt, Birgit and Classen, Carl-Friedrich and Claviez, Alexander and Corbacioglu, Selim and Deubzer, Hedwig E. and Greil, Johann and Gruhn, Bernd and Gungor, Tayfun and Kafa, Kinan and Kuhl, Jorn-Sven and Lang, Peter and Lange, Bjoern Soenke and Meisel, Roland and Muller, Ingo and Sauer, Martin G. and Schlegel, Paul-Gerhardt and Schulz, Ansgar and Stachel, Daniel and Strahm, Brigitte and Wawer, Angela and Peters, Christina and Albert, Michael H. (2022) Incidence of subsequent malignancies after total body irradiation-based allogeneic HSCT in children with ALL - long-term follow-up from the prospective ALL-SCT 2003 trial. LEUKEMIA, 36 (11). pp. 2567-2576. ISSN 0887-6924, 1476-5551
Full text not available from this repository. (Request a copy)Abstract
Total body irradiation (TBI)-based conditioning is associated with superior leukemia-free survival in children with ALL undergoing HSCT. However, the risk for subsequent malignant neoplasms (SMN) remains a significant concern. We analyzed 705 pediatric patients enrolled in the prospective ALL-SCT-BFM-2003 trial and its subsequent registry. Patients >2 years received conditioning with TBI 12 Gy/etoposide (n = 558) and children <= 2 years of age or with contraindications for TBI received busulfan/cyclophosphamide/etoposide (n = 110). The 5- and 10-year cumulative incidence of SMN was 0.02 +/- 0.01 and 0.13 +/- 0.03, respectively. In total, 39 SMN (34 solid tumors, 5 MDS/AML) were diagnosed in 33 patients at a median of 5.8 years (1.7-13.4), exclusively in the TBI group. Of 33 affected patients, 21 (64%) are alive at a median follow-up of 5.1 years (0-9.9) after diagnosis of their first SMN. In univariate analysis, neither age at HSCT, donor type, acute GVHD, chronic GVHD, nor CMV constituted a significant risk factor for SMN. The only significant risk factor was TBI versus non-TBI based conditioning. This analysis confirms and quantifies the increased risk of SMN in children with ALL after conditioning with TBI. Future strategies to avoid TBI will need careful tailoring within prospective, controlled studies to prevent unfavorable outcomes.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | ACUTE LYMPHOBLASTIC-LEUKEMIA; STEM-CELL TRANSPLANTATION; BONE-MARROW-TRANSPLANTATION; SOLID CANCERS; AIEOP-BFM; LYMPHOID IRRADIATION; CUMULATIVE INCIDENCE; THYROID-CARCINOMA; CHILDHOOD; THERAPY; |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Abteilung für Pädiatrische Hämatologie, Onkologie und Stammzelltransplantation |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 12 Dec 2023 14:19 |
| Last Modified: | 12 Dec 2023 14:19 |
| URI: | https://pred.uni-regensburg.de/id/eprint/58775 |
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