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Pediatric Transplants

TBI and melphalan followed by allogeneic hematopoietic SCT in children with advanced hematological malignancies

Bone Marrow Transplantation volume 46, pages 1057–1062 (2011)Cite this article

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Abstract

We evaluated the efficacy and safety of the conditioning regimen that consisted of TBI and melphalan (L-PAM), followed by hematopoietic SCT (HSCT) in 23 children with advanced hematological malignancies. The median age at HSCT was 9 (range, 2–15) years. The underlying diseases were ALL in 16 patients (5 in CR2, 3 in CR3, 6 in relapse (RP) and 2 in induction failure (IF)), AML in 4 patients (3 in RP and 1 in IF) and non-Hodgkin's lymphoma in 3 patients (1 in CR3, 1 in CR4 and 1 in RP). The stem cell sources were BM for 19 patients and cord blood for 4 patients. All patients received the conditioning regimen that consisted of TBI 12 or 13.2 Gy and L-PAM 210 mg/m2. In all, 22 patients engrafted on the median of day 16 (range, 10–23). The regimen was well tolerated and common regimen-related toxicities (RRTs) included grade II stomatitis and grade I hepatic toxicity. The cumulative incidences of RP and TRM were 47.6 and 21.5%, respectively. At a median follow-up of 24.4 months, the probability of disease-free survival was 41.0%. The regimen may provide sufficient anti-leukemic effect without increased RRT for advanced pediatric hematological malignancies.

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Authors and Affiliations

  1. Section of Pediatrics, National Kyusyu Cancer Center, Fukuoka, Japan

    J Inagaki, Y Nagatoshi, M Sakiyama, Y Nomura & H Teranishi

  2. Section of Radiology, National Kyusyu Cancer Center, Fukuoka, Japan

    T Sasaki

  3. Institute for Clinical Research, National Kyusyu Cancer Center, Fukuoka, Japan

    J Okamura

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  1. J Inagaki
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Correspondence to J Inagaki.

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Inagaki, J., Nagatoshi, Y., Sakiyama, M. et al. TBI and melphalan followed by allogeneic hematopoietic SCT in children with advanced hematological malignancies. Bone Marrow Transplant 46, 1057–1062 (2011). https://doi.org/10.1038/bmt.2010.253

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