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)
|