A comprehensive comparison between TBI vs non-TBI-based conditioning regimen in pediatric patients with acute lymphoblastic leukemia: A systematic review and meta-analysis

Ansari, Faezeh; Behfar, Maryam; Jafari, Leila; Mohseni, Rashin; Naji, Parisa; Karamlou, Yalda; Amirzade-Iranaq, Mohammad Hossein; Hamidieh, Amir Ali

doi:10.1016/j.leukres.2023.107416

Leukemia Research

2023

DOI: 10.1016/j.leukres.2023.107416

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A comprehensive comparison between TBI vs non-TBI-based conditioning regimen in pediatric patients with acute lymphoblastic leukemia: A systematic review and meta-analysis

Faezeh Ansari,

Maryam Behfar,

Leila Jafari

et al.

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2024

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Late effects following HSCT for childhood ALL: A national single‐center study using three different modalities of delivery of total body irradiation

Uhlving,

Specht,

Masmas

et al. 2024

Pediatric Blood & Cancer

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BackgroundTotal body irradiation (TBI) is a pivotal part of conditioning prior to hematopoietic stem cell transplantation (HSCT) for childhood acute lymphoblastic leukemia (ALL), yet evidence is sparse regarding the effect of TBI delivery techniques on acute and late toxicities.DesignIn a national cohort of pediatric HSCT‐recipients, we compared three TBI schedules; 12 Gray (Gy) delivered as (i) 4 Gy daily fractions from 2008 to 2011 (n = 12); (ii) 2 Gy fractions twice daily with two‐dimensional (2D) planning technology from 2012 to 2015 (n = 16); and (iii) 2 Gy twice daily with three‐dimensional (3D) planning intensity‐modulated radiotherapy (IMRT) from 2016 to 2020 (n = 14).ResultsThe 5‐year event‐free survival was 75.0%, 81.3%, and 81.3% in Cohorts 1, 2, and 3, respectively. Acute toxicity assessed as maximum ferritin and C‐reactive protein during the first 3 months post HSCT did not differ between cohorts, nor did the time to first hospital discharge (median 28, 32, and 31 days, p = .25). The incidences of acute graft‐versus‐host disease (GvHD) (66%, 56%, 71%) and chronic GvHD (25%, 31%, 14%) were comparable. Pulmonary function assessed by spirometry did not differ significantly. The 5‐year cataract‐free survival was 33.3%, 79%, and 100% in Cohorts 1, 2, and 3, respectively. We found a nonsignificant tendency toward more endocrinopathies in Cohort 1 compared to Cohorts 2 and 3.ConclusionThe change of modality did not result in more relapses. More fractionation led to improvement with a lower incidence of cataract and a tendency toward fewer endocrinopathies. The effect of 3D‐planning‐IMRT technology requires further evaluation in larger studies.

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Late effects following HSCT for childhood ALL: A national single‐center study using three different modalities of delivery of total body irradiation

Uhlving,

Specht,

Masmas

et al. 2024

Pediatric Blood & Cancer

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show abstract

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A comprehensive comparison between TBI vs non-TBI-based conditioning regimen in pediatric patients with acute lymphoblastic leukemia: A systematic review and meta-analysis

Cited by 1 publication

References 41 publications

Late effects following HSCT for childhood ALL: A national single‐center study using three different modalities of delivery of total body irradiation

Late effects following HSCT for childhood ALL: A national single‐center study using three different modalities of delivery of total body irradiation

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