Long-term follow-up of a randomized trial comparing the combination of cyclophosphamide with total body irradiation or busulfan as conditioning regimen for patients receiving HLA-identical marrow grafts for acute myeloblastic leukemia in first complete remission

Blaise, Didier; Maraninchi, D; Michallet, Mauricette; Reiffers, Josy; Jouet, Jean Pierre; Milpied, Noël; Devergié, A; Attal, Michel; Sotto, J. J.; Kuentz, Mathieu; Ifrah, Norbert; Dauriac, Charles; Bordigoni, Pierre; Gratecos, N; Guilhot, Joëlle; Guyotat, Denis; Gluckman, Éliane; Vernant, Jean Paul

doi:10.1182/blood.v97.11.3669

Cited by 81 publications

(50 citation statements)

References 7 publications

(4 reference statements)

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“…Conditioning, therefore, is a confounding variable in this study since there were significantly more patients in the ATG-F group prepared with TBI than in the ATG-S or no ATG group. However, the available randomized studies [40][41][42] concluded on a lower, not a higher relapse incidence, and a slightly more favorable LFS in AML patients prepared with TBI as compared to oral busulfan. This discrepancy between the literature and our results again may be related to the use of ATG concomitant to TBI, which via a weaker GvL effect may lead to an increased relapse risk after TBI.…”

Section: Discussionmentioning

confidence: 99%

Antithymocyte globulin for the prevention of graft-versus-host disease after unrelated hematopoietic stem cell transplantation for acute myeloid leukemia: results from the multicenter German cooperative study group

Basara

Baurmann

Kolbe

et al. 2005

Bone Marrow Transplant

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Section: Discussionmentioning

confidence: 99%

Antithymocyte globulin for the prevention of graft-versus-host disease after unrelated hematopoietic stem cell transplantation for acute myeloid leukemia: results from the multicenter German cooperative study group

Basara

Baurmann

Kolbe

et al. 2005

Bone Marrow Transplant

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“…Traditional techniques of delivering TBI use large open fields and accessories such as body compensators, lung attenuators, and beam spoilers to achieve a dose homogeneity of ±10% over the entire body 1, 3, 4, 5. Randomized trials have demonstrated the effectiveness of TBI conditioning regimes prior to bone marrow transplant 6, 7, 8, 9. However, due to the high dose to both the bone marrow and normal healthy tissues, toxicities and treatment‐related mortalities are a significant concern 10, 11.…”

Section: Introductionmentioning

confidence: 99%

Energy‐dependent OAR sparing and dose conformity for total marrow irradiation of obese patients

Cherpak

Monajemi

Chytyk-Praznik

et al. 2018

J Applied Clin Med Phys

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PurposeTo investigate the effect on target coverage and organs at risk sparing by using 10 versus 6 MV for VMAT total marrow irradiation of obese patients.Methods and MaterialsTwenty‐six total marrow irradiation, TMI, treatment plans delivered between December 2014 and June 2017 were reviewed and 10 were chosen for replanning based on patient characteristics and plan metrics. Beam geometry and isocenter placement were conserved, energy was changed from 6 to 10 MV and plans were reoptimized. Resulting dose distributions were compared to original plans to evaluate any potential advantage of choosing one energy over the other.ResultsTarget coverage and total monitor units were consistent between the 6 and 10 MV plans when averaged over all ten patients. Improvement in the conformity index (−11.0%, P = 0.009) when using 10 MV was statistically significant compared to the 6 MV plans. Volumes of normal tissue receiving 50%, 75%, and 90% Rx all decreased for the 10 MV plans compared to the original 6 MV plans. The mean dose to individual OARs decreased significantly for all investigated structures except for the lenses, oral cavity, and genitalia. The largest decreases in Dmean were found for the rectum (22.4%, P = 0.004) and bladder (18.1%, P = 0.005). The three highest priorities for sparing during plan optimization (lungs, liver, and heart), showed decreases of 7.6%, 16.1%, and 13.0%.ConclusionsUse of a higher energy 10 MV beam provided similar dose to target while achieving increased OAR and normal tissue sparing for the patients reviewed in this study.

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“…A number of randomized studies have compared these regimens in myeloid malignancies. [58][59][60][61][62][63] While there would appear to be broad equivalence of both regimens in patients with CML and early phase AML, studies using oral preparations of Bu suggest superiority of TBI-based regimens in patients with advanced-phase AML. 64 However, the pharmacokinetics of oral Bu are unpredictable resulting in highly variable blood levels.…”

Section: The Role Of Allogeneic Transplantation In Management Of Patimentioning

confidence: 99%

Full-intensity and reduced-intensity allogeneic stem cell transplantation in AML

Craddock

2008

Bone Marrow Transplant

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Allogeneic stem cell transplantation represents the most active form of anti-leukaemic therapy in acute myeloid leukaemia (AML). Advances in transplant technology and supportive care have resulted in improved outcomes in patients allografted using a myeloablative conditioning regimen. At the same time the use of reduced-intensity conditioning regimens has allowed an immunologically mediated graft-versus-leukaemia effect to be exploited in older patients who were previously ineligible for transplantation on the grounds of age or comorbidity. This coupled with the increased availability of alternative stem cell sources, in the form of either unrelated or cord blood donations, has established allogeneic transplantation as a key therapeutic strategy in the treatment of both younger and older adults with AML.

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Long-term follow-up of a randomized trial comparing the combination of cyclophosphamide with total body irradiation or busulfan as conditioning regimen for patients receiving HLA-identical marrow grafts for acute myeloblastic leukemia in first complete remission

Cited by 81 publications

References 7 publications

Antithymocyte globulin for the prevention of graft-versus-host disease after unrelated hematopoietic stem cell transplantation for acute myeloid leukemia: results from the multicenter German cooperative study group

Antithymocyte globulin for the prevention of graft-versus-host disease after unrelated hematopoietic stem cell transplantation for acute myeloid leukemia: results from the multicenter German cooperative study group

Energy‐dependent OAR sparing and dose conformity for total marrow irradiation of obese patients

Full-intensity and reduced-intensity allogeneic stem cell transplantation in AML

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