Antileukemic and long-term effects of two regimens with or without TBI in allogeneic bone marrow transplantation for childhood acute lymphoblastic leukemia.
Between September 1986 and June 1997, 24 children with high-risk ALL in CR1 were allografted after TAM (fractionated TBI, high-dose Ara-C, and melphalan; n = 10) or BAM protocol (busulfan, high-dose Ara-C, and melphalan; n = 14). The EFS for transplants from sibling donors was 33% with TAM and 62% with BAM (P = 0.148). The probability of acute GvHD was 70% with TAM and 15% with BAM (P = 0.003). Four of 17 evaluable patients relapsed: one after TAM and three after BAM. In all, 46 other children transplanted in CR beyond CR1 were studied for sequelae. Long-term side effects were more frequent in TAM vs BAM. In children with ALL, busulfan may be a good alternative to TBI to improve the quality of life.
Dai
Q Y
QY
Department of Pediatrics, Shanghai Second Medical University, Ruijin Hospital, China.
Souillet
G
G
Bertrand
Y
Y
Galambrun
C
C
Bleyzac
N
N
Manel
A M
AM
Bruno
B
B
Souillet
A L
AL
Homole
E
E
Pages
M P
MP
Berlier
P
P
David
M
M
Berthier
J C
JC
Massenavette
B
B
Contamin
B
B
Philippe
N
N
D000293:Adolescent; D016026:Bone Marrow Transplantation / Q000379:methods*; D002066:Busulfan / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D003561:Cytarabine / Q000008:administration & dosage; D005260:Female; D006086:Graft vs Host Disease; D006801:Humans; D016130:Immunophenotyping; D007621:Karyotyping; D008297:Male; D008558:Melphalan / Q000008:administration & dosage; D010755:Organophosphates / Q000008:administration & dosage; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000628:therapy*; D012008:Recurrence; D013997:Time Factors; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous / Q000379:methods*; D016896:Treatment Outcome
D010755:Organophosphates; D003561:Cytarabine; C009524:tributyl phosphate; D002066:Busulfan; D008558:Melphalan