open access

Vol 25, No 3 (2020)
Original research articles
Published online: 2020-05-01
Submitted: 2018-09-14
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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

Nour Ben Abdeljelil, Saloua Ladeb, Talel Dahmani, Lotfi Kochbati, Amel Lakhal, Rym El Fatmi, Lamia Torjemane, Dorra Belloumi, Mounir Besbes, Farouk El Benna, Chiraz Nasr Ben Ammar, Tarek Ben Othman
DOI: 10.1016/j.rpor.2020.03.023
·
Rep Pract Oncol Radiother 2020;25(3):436-441.

open access

Vol 25, No 3 (2020)
Original research articles
Published online: 2020-05-01
Submitted: 2018-09-14

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.

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.

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About this article
Title

Once-a-day fractionated total-body irradiation: A regimen tailored to local logistics in allogeneic stem cell transplantation for acute lymphoblastic leukemia

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 25, No 3 (2020)

Pages

436-441

Published online

2020-05-01

DOI

10.1016/j.rpor.2020.03.023

Bibliographic record

Rep Pract Oncol Radiother 2020;25(3):436-441.

Authors

Nour Ben Abdeljelil
Saloua Ladeb
Talel Dahmani
Lotfi Kochbati
Amel Lakhal
Rym El Fatmi
Lamia Torjemane
Dorra Belloumi
Mounir Besbes
Farouk El Benna
Chiraz Nasr Ben Ammar
Tarek Ben Othman

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