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Outcome of medium-dose VP-16/CY/TBI superior to CY/TBI as a conditioning regimen for allogeneic stem cell transplantation in adult patients with acute lymphoblastic leukemia

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Title: Outcome of medium-dose VP-16/CY/TBI superior to CY/TBI as a conditioning regimen for allogeneic stem cell transplantation in adult patients with acute lymphoblastic leukemia
Authors: Shigematsu, Akio Browse this author
Tanaka, Junji Browse this author
Suzuki, Ritsuro Browse this author
Atsuta, Yoshiko Browse this author
Kawase, Takakazu Browse this author
Ito, Yoichi M. Browse this author
Yamashita, Takuya Browse this author
Fukuda, Takahiro Browse this author
Kumano, Keiki Browse this author
Iwato, Koji Browse this author
Yoshiba, Fumiaki Browse this author
Kanamori, Heiwa Browse this author
Kobayashi, Naoki Browse this author
Fukuhara, Takashi Browse this author
Morishima, Yasuo Browse this author
Imamura, Masahiro Browse this author
Keywords: Acute lymphoblastic leukemia
Stem cell transplantation
Conditioning regimen
Medium-dose VP/CY/TBI
Issue Date: Nov-2011
Publisher: Springer Japan
Journal Title: International Journal of Hematology
Volume: 94
Issue: 5
Start Page: 463
End Page: 471
Publisher DOI: 10.1007/s12185-011-0944-2
PMID: 22042561
Abstract: The choice of conditioning regimen before allogeneic stem cell transplantation (SCT) in patients with acute lymphoblastic leukemia (ALL) is important. We retrospectively compared outcomes of medium-dose VP-16/cyclophosphamide/total body irradiation (VP/CY/TBI) regimen and CY/TBI. Five hundred and twenty-nine patients (VP/CY/TBI: n = 35, CY/TBI: n = 494) who met all of the following criteria were compared: first time for SCT, aged 15-59 years; first or second complete remission at SCT; bone marrow or peripheral blood as stem cell source; and HLA phenotypically matched donor. Median age of the patients was 34 years, and patients who received VP/CY/TBI were younger (28 years vs. 34 years, P = 0.02). Cumulative incidences of relapse and non-relapse mortality (NRM) were higher for patients who received CY/TBI (P = 0.01 for relapse, P < 0.01 for NRM). After a median follow-up period of 36.9 months, 5-year overall survival (OS) rates were 82.2% in the VP/CY/TBI group and 55.2% in the CY/TBI group. OS, and disease-free survival (DFS) in the VP/CY/TBI group were shown to be significantly better by multivariate analysis [hazard ratio: 0.21 (95% confidence interval: 0.06-0.49) for DFS, hazard ratio: 0.25 (95% confidence interval: 0.08-0.59) for OS]. VP/CY/TBI was associated with a lower relapse rate and no increase in NRM, resulting in better survival than that in CY/TBI for adult ALL patients.
Rights: The final publication is available at www.springerlink.com
Type: article (author version)
URI: http://hdl.handle.net/2115/47739
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 重松 明男

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