Prospective Randomized Comparison of Single-Dose Versus Hyperfractionated Total-Body Irradiation in Patients With Hematologic Malignancies

Girinsky, T.; Benhamou, E; Bourhis, Jean; Dhermain, Frédéric; Guillot-Valls, Dolores; Ganansia, V.; Luboinski, M.; Perez, Adriana; Cosset, J.M.; Socié, Gèrard; Baume, D; Bouaouina, N; Briot, E.; Beaudré, A.; Bridier, A.; Pico, J L

doi:10.1200/jco.2000.18.5.981

Cited by 92 publications

(51 citation statements)

References 14 publications

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“…A previous randomized trial had found that recipient conditioning with a regimen of 14.85 Gy fractionated TBI was associated with a lower incidence of interstitial pneumonia and lower overall mortality than 10 Gy. 33 Furthermore, the use of 13.2 Gy in adults or 14.4 Gy in children up to the age of 18 was associated with about the same survival rate among patients transplanted using HLA-A or -B mismatched donors. 20 The study cohort was given an initial CsA dose of 3-7.5 mg/kg/day, and the control cohort one of 3-5 mg/kg/day.…”

Section: Discussionmentioning

confidence: 99%

Association between pretransplant Thymoglobulin and reduced non-relapse mortality rate after marrow transplantation from unrelated donors

Remberger

Storer

Ringdén

et al. 2002

Bone Marrow Transplant

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Summary:A matched cohort study was designed to test the efficacy of polyclonal rabbit antiserum specific for human T cells (Thymoglobulin), administered in vivo on days 1-5 (2 mg/kg/day) before T cell-replete unrelated donor marrow transplantation. Thymoglobulin was given to 52 leukemic patients at Huddinge Hospital. Control patients matched for diagnosis, disease stage, age and treated with a similar regimen, apart from the omission of Thymoglobulin, were selected in Seattle during the same period (n ‫؍‬ 104). All received conditioning with cyclophosphamide and TBI. In the study group all patients received 10 Gy single dose TBI, while the controls were given 12-14.4 Gy fractionated TBI. GVHD prophylaxis was cyclosporine and methotrexate. Patients were treated for grade I acute GVHD in the study group, and for grade II GVHD in the control group. Multivariable analyses were adjusted for patient and donor age and CMV serology, HLA matching, donor gender and marrow cell dose. Non-relapse mortality was lower in the study patients (hazard ratio ‫؍‬ 0.30, 95% CI 0.12-0.75, P value ‫؍‬ 0.005). The 5-year cumulative incidence of non-relapse mortality was 19% in the study cohort, and 35% in the control cohort. Overall mortality was also lower in study patients (hazard ratio 0.51, 95% CI 0.27-0.97, P value ‫؍‬ 0.03). No significant difference in the risk of relapse was seen (P ‫؍‬ 0.63). This suggests that Thymoglobulin during conditioning may reduce non-relapse mortality after unrelated donor marrow transplantation.

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Section: Discussionmentioning

confidence: 99%

Association between pretransplant Thymoglobulin and reduced non-relapse mortality rate after marrow transplantation from unrelated donors

Remberger

Storer

Ringdén

et al. 2002

Bone Marrow Transplant

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“…The major risk factors identified are: previous hepatic alterations, previous abdominal irradiation, 7,16 recent use of vancomycin, 17 a second allogeneic graft, 17 TBI associated with CY, 18,19 grafts in children treated for neuroblastoma, 16,20,21 conditioning regimens combining BU and CY and/or melphalan (Mel). 8,16,21,22 Unlike Cesaro et al, 23 we found no correlation between age and HVOD.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for hepatic veno-occlusive disease: a retrospective unicentric study in 116 children autografted after a high-dose BU-thiotepa regimen

Cacchione

Lemaître

Couanet

et al. 2008

Bone Marrow Transplant

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At our Institute, during the last decade, the incidence of hepatic veno-occlusive disease (HVOD) appears to be on the increase among pediatric patients treated with BUthiotepa (BU-TTP)-conditioning regimen. We thus performed a retrospective analysis to identify the risk factors for HVOD, which could explain such a change. In total, 116 patients treated at Institut Gustave Roussy, between May 1998 and December 2005 were eligible for this study having received BU-TTP as their first high-dose chemotherapy regimen, followed by autologous hematopoietic SCT (AHSCT). According to McDonald's clinical criteria, HVOD was diagnosed in 31% of these children. Demographic, clinical, biological and therapeutic parameters were evaluated in uni-and multivariate analyses that showed a significant correlation between previous carboplatin therapy and risk of developing post transplant HVOD (P ¼ 0.028). Comparable results were found for etoposide (P ¼ 0.048). In addition, a correlation between HVOD and risk of post transplant death was linked to its association with other types of organ failure (P ¼ 0.029). This study demonstrates that previous VPCARBO administration in conventional chemotherapy significantly increases the risk of HVOD among brain tumor patients later consolidated with BU-TTP followed by AHSCT.

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“…The incidence of VOD, transplant-related morbidity and mortality decreased following the improved insight to the biology of HSCT, the use of reduced-intensity regimens, i.v. or dose-adjusted busulfan, fractionated TBI regimens and T-cell depletion [26][27][28][29][30]. Despite these advances, our current analysis demonstrated no decrease in the incidence of VOD over time.…”

Section: Discussionmentioning

confidence: 50%

Defibrotide for Prevention and Treatment of Veno-Occlusive Disease in Adults: Single-Center Experience

Yonal¹,

Kalayoğlu-Beşışık²

2014

J Bone Marrow Res

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Prospective Randomized Comparison of Single-Dose Versus Hyperfractionated Total-Body Irradiation in Patients With Hematologic Malignancies

Abstract: The efficacy of HTBI is probably higher than that of STBI. Both regimens induce similar toxicity with the exception of VOD of the liver, the incidence of which is significantly more pronounced in the STBI group.

Cited by 92 publications

References 14 publications

Association between pretransplant Thymoglobulin and reduced non-relapse mortality rate after marrow transplantation from unrelated donors

Association between pretransplant Thymoglobulin and reduced non-relapse mortality rate after marrow transplantation from unrelated donors

Risk factors for hepatic veno-occlusive disease: a retrospective unicentric study in 116 children autografted after a high-dose BU-thiotepa regimen

Defibrotide for Prevention and Treatment of Veno-Occlusive Disease in Adults: Single-Center Experience

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