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Low toxicity of a conditioning with 8‐Gy total body irradiation, fludarabine and cyclophosphamide as preparative regimen for allogeneic hematopoietic stem cell transplantation in pediatric hematological malignancies
Author(s) -
Yanagisawa Ryu,
Nakazawa Yozo,
Sakashita Kazuo,
Tanaka Miyuki,
Shikama Naoto,
Kamijo Takehiko,
Shiohara Masaaki,
Koike Kenichi
Publication year - 2009
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/j.1399-3046.2008.01065.x
Subject(s) - medicine , fludarabine , total body irradiation , cyclophosphamide , regimen , gastroenterology , transplantation , etoposide , hematopoietic stem cell transplantation , hemorrhagic cystitis , surgery , oncology , chemotherapy
We here report the efficacy and toxicity of a conditioning regimen with fractionated 8‐Gy TBI, fludarabine, and cyclophosphamide in allogeneic HSCT for pediatric hematological malignancies. Among 22 children who received related or unrelated HSCT, nine were transplanted with refractory disease and/or from HLA two or more loci‐mismatched family donors. None of the patients developed graft failure. The Seattle grading system revealed that 18 patients had no RRT, and the remaining patients had grade I gastrointestinal toxicity alone. The estimated overall survival and leukemia‐free survival at two yr were 57.1% and 48.0%, respectively, in 10 patients with acute lymphoblastic leukemia; 91.7% and 71.3%, respectively, in 12 patients with myeloid leukemia. The incidence of TRM was 4.8% at two yr. The rates of RRT above grade II and TRM in an 8‐Gy TBI‐containing regimen were significantly lower than the data of historical control patients who underwent 12‐Gy TBI and cyclophosphamide with or without etoposide. The intermediate‐dose TBI‐based conditioning regimen may confer successful engraftment combined with minimized RRT, although its efficacy should be further evaluated.