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Impact of low-dose TBI on outcomes of reduced intensity conditioning allogeneic hematopoietic stem cell transplantation for AML

Bone Marrow Transplantation volume 51, pages 604–606 (2016)Cite this article

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Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a curative therapy for patients with advanced hematologic malignancy, including those with AML.1 However, allo-HSCT after conventional myeloablative conditioning (MAC) may be associated with a high rate of transplant-related complications. Reduced intensity conditioning (RIC) was developed with the purpose of reducing regimen-related toxicity.2, 3 RIC is increasingly used for allo-HSCT for AML patients who are otherwise considered unfit for MAC.

The primary objective of low-dose TBI in RIC is inhibition of the host immune response to facilitate engraftment.4, 5 Several studies have suggested that the addition of low-dose TBI to the conditioning regimen improved outcomes of transplantation.6, 7 However, favorable outcomes of non-TBI-based RIC transplantation were also reported.8 Thus, the impact of low-dose TBI on outcomes after allo-HSCT remains controversial, and it is unknown whether the addition of low-dose TBI to RIC is beneficial for AML patients. Therefore, we conducted a retrospective analysis to elucidate the clinical impact of low-dose TBI on outcomes after allo-HSCT from a HLA-matched-related donor in the setting of fludarabine-based RIC.

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References

  1. Dohner H, Estey EH, Amadori S, Appelbaum FR, Buchner T, Burnett AK et al. Diagnosis and management of acute myeloid leukemia in adults: recommendations from an international expert panel, on behalf of the European LeukemiaNet. Blood 2010; 115: 453–474.

    Article  Google Scholar 

  2. Lazarus HM, Rowe JM . Reduced-intensity conditioning for acute myeloid leukemia: is this strategy correct. Leukemia 2006; 20: 1673–1682.

    Article  CAS  Google Scholar 

  3. Barrett AJ, Savani BN . Stem cell transplantation with reduced-intensity conditioning regimens: a review of ten years experience with new transplant concepts and new therapeutic agents. Leukemia 2006; 20: 1661–1672.

    Article  CAS  Google Scholar 

  4. Hill-Kayser CE, Plastaras JP, Tochner Z, Glatstein E . TBI during BM and SCT: review of the past, discussion of the present and consideration of future directions. Bone Marrow Transplant 2011; 46: 475–484.

    Article  CAS  Google Scholar 

  5. Gyurkocza B, Storb R, Storer BE, Chauncey TR, Lange T, Shizuru JA et al. Nonmyeloablative allogeneic hematopoietic cell transplantation in patients with acute myeloid leukemia. J Clin Oncol 2010; 28: 2859–2867.

    Article  Google Scholar 

  6. Russell JA, Irish W, Balogh A, Chaudhry MA, Savoie ML, Turner AR et al. The addition of 400 cGY total body irradiation to a regimen incorporating once-daily intravenous busulfan, fludarabine, and antithymocyte globulin reduces relapse without affecting nonrelapse mortality in acute myelogenous leukemia. Biol Blood Marrow Transplant 2010; 16: 509–514.

    Article  CAS  Google Scholar 

  7. Rodrigues CA, Sanz G, Brunstein CG, Sanz J, Wagner JE, Renaud M et al. Analysis of risk factors for outcomes after unrelated cord blood transplantation in adults with lymphoid malignancies: a study by the Eurocord-Netcord and lymphoma working party of the European group for blood and marrow transplantation. J Clin Oncol 2009; 27: 256–263.

    Article  Google Scholar 

  8. de Lima M, Couriel D, Thall PF, Wang X, Madden T, Jones R et al. Once-daily intravenous busulfan and fludarabine: clinical and pharmacokinetic results of a myeloablative, reduced-toxicity conditioning regimen for allogeneic stem cell transplantation in AML and MDS. Blood 2004; 104: 857–864.

    Article  CAS  Google Scholar 

  9. Deeg HJ, Sandmaier BM . Who is fit for allogeneic transplantation? Blood 2010; 116: 4762–4770.

    Article  CAS  Google Scholar 

  10. Giralt S, Ballen K, Rizzo D, Bacigalupo A, Horowitz M, Pasquini M et al. Reduced-intensity conditioning regimen workshop: defining the dose spectrum. Report of a workshop convened by the center for international blood and marrow transplant research. Biol Blood Marrow Transplant 2009; 15: 367–369.

    Article  Google Scholar 

  11. Slovak ML, Kopecky KJ, Cassileth PA, Harrington DH, Theil KS, Mohamed A et al. Karyotypic analysis predicts outcome of preremission and postremission therapy in adult acute myeloid leukemia: a Southwest Oncology Group/Eastern Cooperative Oncology Group Study. Blood 2000; 96: 4075–4083.

    CAS  Google Scholar 

  12. Bacigalupo A, Socie G, Lanino E, Prete A, Locatelli F, Locasciulli A et al. Fludarabine, cyclophosphamide, antithymocyte globulin, with or without low dose total body irradiation, for alternative donor transplants, in acquired severe aplastic anemia: a retrospective study from the EBMT-SAA Working Party. Haematologica 2010; 95: 976–982.

    Article  CAS  Google Scholar 

  13. Mohty MLM, Janssen J, Mufti G, Cornelissen JJ, Mipied N et al. Comparison of low-dose TBI-Based reduced-intensity conditioning (RIC) vs chemotherapy-based RIC prior to allogeneic stem cell transplantation from an HLA identical sibling donor for AML in first complete remission. Bone marrow transplant 2010; 45 (Suppl 2): S1–427.

    Google Scholar 

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Acknowledgements

We thank the medical, nursing, data processing and laboratory staff at the Japan Society for Hematopoietic Cell Transplantation for their valuable contributions to this study through their dedicated care of the patients.

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Authors and Affiliations

  1. Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan

    J Aoki, H Kanamori & M Tanaka

  2. Department of Hematology and Oncology, National Cancer Center Hospital East, Kashiwanoha, Kashiwa, Japan

    S Seo

  3. Division of Hematopoietic stem cell transplantation, National Cancer Center Hospital, Tokyo, Japan

    T Fukuda

  4. Department of Hematology/Oncology, Tokai University School of Medicine, Isehara, Japan

    M Onizuka

  5. Department of Hematology, Sapporo Hokuyu Hospital, Sapporo, Japan

    N Kobayashi

  6. Department of Hematology/Oncology, Kyoto University Hospital, Kyoto, Japan

    T Kondo

  7. Department of Hematology and Oncology, Anjo Kosei Hospital, Aichi, Japan

    M Sawa

  8. Department of Hematology, Toranomon Hospital, Tokyo, Japan

    N Uchida

  9. Department of Hematology, Hiroshima Red Cross Hospital & Atomic-bomb Survivors Hospital, Hiroshima, Japan

    K Iwato

  10. Department of Hematology and Oncology, Hiroshima University Hospital, Hiroshima, Japan

    T Icihnohe

  11. Japanese Data Center for Hematopietic Cell Transplantation, Nagoya, Japan

    Y Atsuta

  12. Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Y Atsuta

  13. Division of Clinical Oncology and Hematology, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan

    S Yano

  14. Division of Hematology, Department of Internal Medicine, Aichi Medical University, Aichi, Japan

    A Takami

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  1. J Aoki
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  2. S Seo
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  3. H Kanamori
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  4. M Tanaka
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  7. N Kobayashi
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  9. M Sawa
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  13. Y Atsuta
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  14. S Yano
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  15. A Takami
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Correspondence to J Aoki.

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The authors declare no conflict of interest.

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Aoki, J., Seo, S., Kanamori, H. et al. Impact of low-dose TBI on outcomes of reduced intensity conditioning allogeneic hematopoietic stem cell transplantation for AML. Bone Marrow Transplant 51, 604–606 (2016). https://doi.org/10.1038/bmt.2015.297

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