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Excellent Outcome of Allogeneic Hematopoietic Stem Cell Transplantation Using a Conditioning Regimen with Medium-Dose VP-16, Cyclophosphamide and Total-Body Irradiation for Adult Patients with Acute Lymphoblastic Leukemia

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Title: Excellent Outcome of Allogeneic Hematopoietic Stem Cell Transplantation Using a Conditioning Regimen with Medium-Dose VP-16, Cyclophosphamide and Total-Body Irradiation for Adult Patients with Acute Lymphoblastic Leukemia
Authors: Shigematsu, Akio Browse this author →KAKEN DB
Kondo, Takeshi Browse this author →KAKEN DB
Yamamoto, Satoshi Browse this author
Sugita, Junichi Browse this author →KAKEN DB
Onozawa, Masahiro Browse this author →KAKEN DB
Kahata, Kaoru Browse this author
Endo, Tomoyuki Browse this author
Shiratori, Soichi Browse this author
Ota, Shuichi Browse this author
Obara, Masato Browse this author
Wakasa, Kentaro Browse this author
Takahata, Mutsumi Browse this author
Takeda, Yukari Browse this author
Tanaka, Junji Browse this author →KAKEN DB
Hashino, Satoshi Browse this author →KAKEN DB
Nishio, Mitsufumi Browse this author →KAKEN DB
Koike, Takao Browse this author →KAKEN DB
Asaka, Masahiro Browse this author →KAKEN DB
Imamura, Masahiro Browse this author →KAKEN DB
Keywords: VP-16
Acute lymphoblastic leukemia
Adult
Hematopoietic stem cell transplantation
Conditioning regimen
Issue Date: May-2008
Publisher: Elsevier
Journal Title: Biology of Blood and Marrow Transplantation
Volume: 14
Issue: 5
Start Page: 568
End Page: 575
Publisher DOI: 10.1016/j.bbmt.2008.02.018
PMID: 18410899
Abstract: We retrospectively evaluated the outcomes of 37 adult patients with acute lymphoblastic leukemia (ALL) undergoing allogeneic hematopoietic stem cell transplantation (allo-SCT) conditioned with medium-dose VP-16 (VP, 30 mg/kg), cyclophosphamide (CY, 120 mg/kg), and fractionated total-body irradiation (TBI, 12 Gy) (medium-dose VP/CY/TBI). The median age of the patients was 26 years. Thirteen patients underwent transplantation from HLA-matched related donors (MRD), 18 patients underwent transplantation from HLA-matched unrelated donors (MUD), and 6 patients underwent transplantation from HLA-mismatched donors (MMD). Thirty-two patients received bone marrow and 4 patients received peripheral blood stem cells. Ten patients were Philadelphia chromosome-positive (Ph+) and 35 patients were in complete remission (CR) at transplantation. All of the patients achieved engraftment, and grade 3 organ toxicity before engraftment occurred in 27 patients. Grade II-III acute graft-versus-host disease (GVHD) and chronic GVHD (cGVHD) occurred in 15 and 18 patients, respectively. No patient developed grade IV acute GVHD (aGVHD) or died of GVHD. At median follow-up of 35.1 months, 32 patients were alive and all Ph+ patients were alive. Three patients died of relapse and 2 died of transplant-related mortality (TRM). The actuarial 3-year overall survival (OS) rate, relapse rate, and TRM rate were 89.2%, 8.1%, and 5.4%, respectively. Non-CR at transplantation, MRD, and no aGVHD were significant adverse prognostic factors for survival. Medium-dose VP/CY/TBI for adult ALL patients was associated with lower relapse rate and no increase in toxicity, resulting in better survival.
Rights: https://creativecommons.org/licenses/by-nc-nd/4.0/
Type: article
URI: http://hdl.handle.net/2115/62833
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: 小池 隆夫

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