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Comparison of total body irradiation versus non- total body irradiation containing regimens for de novo acute myeloid leukemia in children.

全身照射与含非全身照射方案治疗儿童初治急性髓系白血病的比较。

  • 影响因子:4.07
  • DOI:10.3324/haematol.2020.249458
  • 作者列表:"Dandoy CE","Davies SM","Ahn KW","He Y","Kolb AE","Levine J","Bo-Subait S","Abdel-Azim H","Bhatt N","Chewing J","Gadalla S","Gloude N","Hayashi R","Lalefar NR","Law J","MacMillan M","O'Brien T","Prestidge T","Sharma A","Shaw P","Winestone L","Eapen M
  • 发表时间:2020-06-18
Abstract

With limited data comparing hematopoietic cell transplant outcomes between myeloablative total body irradiation (TBI) containing and non-TBI regimens in children with de novo acute myeloid leukemia, the aim of this study was to compare transplant-outcomes between these regimens. Cox regression models were used to compare transplant-outcomes after TBI and non-TBI regimens in 624 children transplanted between 2008 and 2016. Thirty two percent (n=199) received TBI regimens whereas 68% (n=425) received non-TBI regimens. Five-year non-relapse mortality was higher with TBI regimens (22% vs. 11%, p<0.0001) but relapse was lower (23% vs. 37%, p<0.0001) compared to non-TBI regimens. Consequently, overall (62% vs. 60%, p=1.00) and leukemia-free survival (55% vs. 52%, p=0.42) did not differ between treatment groups. Grade II-IV acute GVHD was higher with TBI regimens (56% vs. 27%, p<0.0001) but not chronic GVHD. The 3-year incidence of gonadal or growth hormone deficiency was higher with TBI regimens (24% vs. 8%, p<0.001) but there were no differences in late pulmonary, cardiac or renal impairment. In the absence of a survival advantage, the choice of TBI or non-TBI regimen merits careful consideration with the data favoring non-TBI regimens to limit the burden of morbidity associated with endocrine dysfunction.

摘要

有限的数据比较了含清髓性全身照射 (TBI) 和非 TBI 方案治疗初治急性髓系白血病患儿的造血细胞移植结局,本研究的目的是比较这些方案之间的移植结果。采用 Cox 回归模型比较 2008 年至 624 年间移植的 2016 例儿童 TBI 和非 TBI 方案后的移植结局。2% (n = 199) 接受了 TBI 方案,而 68% (n = 425) 接受了非 TBI 方案。TBI 方案的 5 年非复发死亡率较高 (22% vs. 11%,p<0.0001) 但复发较低 (23% vs. 37%,p<0.0001) 与非 TBI 方案相比。因此,总体 (62% vs. 60%,p = 1.00) 和无白血病生存率 (55% vs. 52%,p = 0.42) 在治疗组之间没有差异。TBI 方案的 II-IV 级急性 GVHD 较高 (56% vs. 27%,p<0.0001),但慢性 GVHD 不明显。TBI 方案的 3 年性腺或生长激素缺乏症发生率较高 (24% vs. 8%,p<0.001),但晚期肺、心脏或肾功能损害无差异。在缺乏生存优势的情况下,TBI 或非 TBI 方案的选择值得仔细考虑,数据有利于非 TBI 方案,以限制与内分泌功能障碍相关的发病率负担。

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关键词: 暂无
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影响因子:3.07
发表时间:2020-02-01
来源期刊:Oncology reports
DOI:10.3892/or.2020.7457
作者列表:["Li C","Xu Y","Xin P","Zheng Y","Zhu X"]

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影响因子:3.78
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DOI:10.1016/j.biopha.2020.109811
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