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Conditioning Regimens

In haematopoietic SCT for acute leukemia TBI impacts on relapse but not survival: results of a multicentre observational study

Bone Marrow Transplantation volume 48, pages 908–914 (2013)Cite this article

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A Corrigendum to this article was published on 04 December 2013

Abstract

The aim of this study was to determine whether parameters related to TBI impacted upon OS and relapse in patients with acute leukemia in CR who underwent haematopoietic SCT (HSCT) in 11 Italian Radiation Oncology Centres. Data were analysed from 507 patients (313 males; 194 females; median age 15 years; 318 with ALL; 188 with AML; 1 case not recorded). Besides 128 autologous transplants, donors included 192 matched siblings, 74 mismatched family members and 113 unrelated individuals. Autologous and allogeneic transplants were analysed separately. Median follow-up was 40.1 months. TBI schedules and HSCT type were closely related. Uni- and multi-variate analyses showed no parameter was significant for OS or relapse in autologous transplantation. Multivariate analysis showed type of transplant and disease impacted significantly on OS in allogeneic transplantation. Disease, GVHD and TBI dose were risk factors for relapse. This analysis illustrates that Italian Transplant Centre use of TBI is in line with international practice. Most Centres adopted a hyperfractionated schedule that is used worldwide (12 Gy in six fractions over 3 days), which appears to have become standard. TBI doses impacted significantly upon relapse rates.

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Acknowledgements

This work was partly supported by the ‘Quality Indicators for Radiotherapy’ Project, funded by the Italian Ministry of Health. The authors would like to thank Geraldine A Boyd for editing this paper. The authors would also like to thank, for having collected data, Paola Anselmo, Michele Benedetti, Massimo Berger, Francesco Borgia, Maria Samaritana Buzzaccarini, Silvia Durzu, Rita Felicini, Chiara Julita, Francesca Mascioni, Filippo Milano, Maddalena Giannini, Tindara Munafò, Dolores Tomasini, Stefania Varotto, Lisa Vicenzi, Elena Viganò, Elisabetta Vitali.

Italian TBI Working group

Cynthia Aristei: Università degli Studi e Azienda Ospedaliera - Struttura Complessa di Radioterapia Oncologica - Ospedale Santa Maria della Misericordia Perugia; Lorenzo Falcinelli: Struttura Complessa di Radioterapia Oncologica Azienda Ospedaliera Perugia; Gianni Gobbi, Carlo Raymondi: Servizio di Fisica Sanitaria; Azienda Ospedaliera, Ospedale Santa Maria della Misericordia, Perugia; Franco Aversa: Ematologia e Centro Trapianti Midollo Osseo, Università di Parma e Ospedale Maggiore, Parma; Antonella Santucci: Università degli Studi e Azienda Ospedaliera – Centro Trapianto Midollo Osseo - Santa Maria della Misericordia, Perugia

Enza Barbieri: Università di Bologna e Divisione di Radioterapia Ospedale S.Orsola Malpighi, Bologna; Andrea Ferri: Servizio di Fisica Sanitaria Ospedale S.Orsola Malpighi, Bologna; Giuseppe Bandini: Istituto di Ematologia Ospedale S.Orsola Malpighi, Bologna; Andrea Pession: Dipartimento Scienze Pediatriche, Ospedale S.Orsola Malpighi, Bologna

Stefano Maria Magrini: Istituto del Radio «O.Alberti» Università degli Studi e Spedali Civili, Brescia; Filippo Bertoni: UOC di Radioterapia Oncologica, Azienda Ospedaliero-Univeristaria Policlinico di Modena, Modena; Marco Galelli: Servizio di Fisica Sanitaria Spedali Civili, Brescia; Sandro Tonoli: Radioterapia Spedali Civili, Brescia; Michela Buglione di Monale e Bastia: Cattedra di Radioterapia, Università di Brescia

Renzo Corvò: Università degli Studi e Istituto Nazionale per la Ricerca sul Cancro, Genova; Franca Foppiano: Servizio di Fisica Sanitaria, ASL5, La Spezia; Salvina Barra: Divisione di Radioterapia Oncologica Istituto Nazionale per la Ricerca sul Cancro, Genova; Andrea Bacigalupo, Francesco Frassoni, Barbara Bruno: Centro Trapianto Midollo Osseo Ospedale San Martino, Genova; Giorgio Dini: Unità di Onco-Ematologia Pediatrica Ospedale Gaslini, Genova; Maura Faraci: Unità Trapianto Midollo Osseo Ospedale Gaslini, Genova

Gianstefano Gardani: U.O. di Radioterapia Oncologica Università di Milano «La Bicocca» e Ospedale S. Gerardo, Monza; Cornelio Uderzo: Ematologia Pediatrica Ospedale S. Gerardo, Monza; Andrea Crespi: Servizio di Fisica Sanitaria Ospedale S. Gerardo, Monza

Giovanni Scarzello: Radioterapia Azienda Ospedaliera, Padova; Roberto Zandonà: Servizio di Fisica Sanitaria Azienda Ospedaliera, Padova; Chiara Messina: Ematologia Azienda Ospedaliera, Padova

Vittorio Donato: Dipartimento di Radioterapia, Ospedale San Camillo-Forlanini, Roma; Lavinia Grapulin: Policlinico Umberto I - Radioterapia - Istituto di Radiologia Università «La Sapienza», Roma; Cinzia Di Felice, Elisabetta Di Castro: Policlinico Umberto I - Fisica Sanitaria - Istituto di Radiologia Università «La Sapienza», Roma; Anna Paola Iori: Policlinico Umberto I – Ematologia- Università «La Sapienza», Roma; Walter Barbieri: Policlinico Umberto I – Ematologia- Università «La Sapienza», Roma; William Arcese: Dipartimento di Ematologia, Unità di Trapianto, Università di Roma “Tor Vergata”, Roma

Michele Troiano, Salvatore Parisi: Divisione di Radioterapia Oncologica – IRCCS Casa Sollievo della Sofferenza, S.Giovanni Rotondo; Alberto Maiorana: Servizio di Fisica Sanitaria – IRCCS Casa Sollievo della Sofferenza, S.Giovanni Rotondo; Angelo Michele Carella: Divisione di Ematologia, IRCCS Azienda Ospedaliera Universitaria San Martino, Genova

Umberto Ricardi, Giuseppe Rossi, Andrea Riccardo Filippi: Radioterapia Ospedale San Giovanni Battista «Le Molinette», Torino; Riccardo Ragona: Servizio di Fisica Sanitaria Ospedale San Giovanni Battista «Le Molinette», Torino

Luigi Tomio: Radioterapia Oncologica, Ospedale Santa Chiara, Trento

Rosa Bianca Guglielmi, Cristina Baiocchi: Radioterapia Ospedale San Bortolo, Vicenza; Paolo Scalchi: Servizio di Fisica Sanitaria Ospedale San Bortolo, Vicenza; Roberto Raimondi: Ematologia Ospedale San Bortolo, Vicenza

Cristiana Vidali S.C.: Radioterapia Azienda Ospedaliero-Universitaria “Ospedali Riuniti”, Trieste; Natasha Maximova: Oncoematologia Pediatrica, Istituto per l’infanzia ed Ospedale specializzato pediatrico regionale - IRCCS “Burlo Garofolo”, Trieste

Author information

Author notes

  1. Members of the ‘Italian TBI working group’ are listed before the references.

Authors and Affiliations

  1. Radiation Oncology Section, University of Perugia and Perugia General Hospital, Perugia, Italy

    C Aristei

  2. Hematology and Clinical Immunology Section, University of Perugia, Perugia, Italy

    A Santucci

  3. Department of Radiation Oncology, National Cancer Research Institute, University of Genoa, Genoa, Italy

    R Corvò

  4. Department of Radiation Oncology, San Gerardo Hospital, University of Milan-Bicocca, Monza, Italy

    G Gardani

  5. Department of Radiation Oncology, University of Turin, San Giovanni Battista Hospital, Turin, Italy

    U Ricardi

  6. Department of Radiotherapy, Institute of Oncology, Padova, Italy

    G Scarzello

  7. Department of Radiation Oncology, University of Brescia, Brescia, Italy

    S M Magrini

  8. Department of Radiotherapy, Ospedale San Camillo-Forlanini, Rome, Italy

    V Donato

  9. Radiation Oncology Division, Santa Maria della Misericordia Hospital, Perugia, Italy

    L Falcinelli

  10. Department of Hematology, Bone Marrow Transplantation Unit, San Martino Hospital, Genoa, Italy

    A Bacigalupo

  11. Department of Paediatric Oncology and Hematology, IRCCS Ospedale Pediatrico Bambino Gesù, Roma and University of Pavia, Pavia, Italy

    F Locatelli

  12. Department of Hematology and Bone Marrow Transplantation Centre, University of Parma and Ospedale Maggiore, Parma, Italy

    F Aversa

  13. Division of Radiation Oncology, Sant’Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy

    E Barbieri

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  1. C Aristei
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Consortia

Italian TBI working group

  • Cynthia Aristei
  • , Lorenzo Falcinelli
  • , Gianni Gobbi
  • , Carlo Raymondi
  • , Franco Aversa
  • , Antonella Santucci
  • , Enza Barbieri
  • , Andrea Ferri
  • , Giuseppe Bandini
  • , Andrea Pession
  • , Stefano Maria Magrini
  • , Filippo Bertoni
  • , Marco Galelli
  • , Sandro Tonoli
  • , Michela Buglione di Monale e Bastia
  • , Renzo Corvò
  • , Franca Foppiano
  • , Salvina Barra
  • , Andrea Bacigalupo
  • , Francesco Frassoni
  • , Barbara Bruno
  • , Giorgio Dini
  • , Maura Faraci
  • , Gianstefano Gardani
  • , Cornelio Uderzo
  • , Andrea Crespi
  • , Giovanni Scarzello
  • , Roberto Zandonà
  • , Chiara Messina
  • , Vittorio Donato
  • , Lavinia Grapulin
  • , Cinzia Di Felice
  • , Elisabetta Di Castro
  • , Anna Paola Iori
  • , Walter Barbieri
  • , William Arcese
  • , Michele Troiano
  • , Salvatore Parisi
  • , Alberto Maiorana
  • , Angelo Michele Carella
  • , Umberto Ricardi
  • , Giuseppe Rossi
  • , Andrea Riccardo Filippi
  • , Riccardo Ragona
  • , Luigi Tomio
  • , Rosa Bianca Guglielmi
  • , Cristina Baiocchi
  • , Paolo Scalchi
  • , Roberto Raimondi
  • , Cristiana Vidali S.C.
  •  & Natasha Maximova

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Correspondence to C Aristei.

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Aristei, C., Santucci, A., Corvò, R. et al. In haematopoietic SCT for acute leukemia TBI impacts on relapse but not survival: results of a multicentre observational study. Bone Marrow Transplant 48, 908–914 (2013). https://doi.org/10.1038/bmt.2013.66

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