| Title: |
Thiotepa-Based Regimens Are Valid Alternatives to Total Body Irradiation-Based Reduced-Intensity Conditioning Regimens in Patients with Acute Lymphoblastic Leukemia: A Retrospective Study on Behalf of the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation |
| Authors: |
Battipaglia G.; Labopin M.; Mielke S.; Ruggeri A.; Nur Ozkurt Z.; Bourhis J. H.; Rabitsch W.; Yakoub-Agha I.; Grillo G.; Sanz J.; Arcese W.; Novis Y.; Fegueux N.; Spyridonidis A.; Giebel S.; Nagler A.; Ciceri F.; Mohty M. |
| Contributors: |
Battipaglia, G.; Labopin, M.; Mielke, S.; Ruggeri, A.; Nur Ozkurt, Z.; Bourhis, J. H.; Rabitsch, W.; Yakoub-Agha, I.; Grillo, G.; Sanz, J.; Arcese, W.; Novis, Y.; Fegueux, N.; Spyridonidis, A.; Giebel, S.; Nagler, A.; Ciceri, F.; Mohty, M. |
| Publisher Information: |
Elsevier B.V. |
| Publication Year: |
2024 |
| Subject Terms: |
Acute lymphoblastic leukemia; Thiotepa; Total body irradiation; Transplantation |
| Description: |
Total body irradiation (TBI) at myeloablative doses is superior to chemotherapy-based regimens in young patients with acute lymphoblastic leukemia (ALL) undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT). However, in elderly and unfit patients, in whom reduced-intensity conditioning (RIC) regimens are preferred, whether a TBI-based or a chemotherapy-based approach is better is unexplored. Thiotepa can be used as part of ALL conditioning regimens. The current study aimed to compare transplantation outcomes after RIC with TBI-based or thiotepa-based regimens in patients with ALL. The study cohort comprised patients aged ≥40 years undergoing allo-HSCT for ALL in first complete remission between 2000 and 2020 who received an RIC regimen containing either TBI (4 to 6 Gy) or thiotepa. We identified a total of 265 patients, including 117 who received a TBI-based RIC regimen and 148 who received a thiotepa-based RIC regimen. Univariate analysis revealed no significant differences in the following transplantation outcomes for TBI versus thiotepa: relapse, 23% versus 28% (P =.24); nonrelapse mortality, 20% versus 26% (P =.61); leukemia-free survival, 57% versus 46% (P =.12); overall survival, 67% versus 56% (P =.18); graft-versus-host disease (GVHD]/relapse-free survival, 45% versus 38% (P =.21); grade II-IV acute GVHD, 30% in both groups (P =.84); grade III-IV acute GVHD, 9% versus 10% (P =.89). The sole exception was the incidence of chronic GVHD, which was higher in the recipients of TBI-based regimens (43% versus 29%; P =.03). However, multivariate analysis revealed no differences in transplantation outcomes between the 2 groups. In patients aged ≥40 years receiving RIC, use of a thiotepa-based regimen may represent a valid alternative to TBI-based regimens, as no differences were observed in the main transplantation outcomes. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
info:eu-repo/semantics/altIdentifier/pmid/37816471; info:eu-repo/semantics/altIdentifier/wos/WOS:001159261500001; volume:30; issue:1; firstpage:95; lastpage:95; numberofpages:1; journal:TRANSPLANTATION AND CELLULAR THERAPY; https://hdl.handle.net/20.500.11768/164886; https://www.sciencedirect.com/science/article/pii/S2666636723015828?via=ihub |
| DOI: |
10.1016/j.jtct.2023.09.028 |
| Availability: |
https://hdl.handle.net/20.500.11768/164886; https://doi.org/10.1016/j.jtct.2023.09.028; https://www.sciencedirect.com/science/article/pii/S2666636723015828?via=ihub |
| Rights: |
info:eu-repo/semantics/openAccess ; license:Creative commons ; license uri:http://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.14210043 |
| Database: |
BASE |