No improvement of survival with reduced- versus high-intensity conditioning for allogeneic stem cell transplants in Ewing tumor patients.
BACKGROUND
Outcomes of Ewing tumor (ET) patients treated with allogeneic stem cell transplantation (allo-SCT) were compared regarding the use of reduced-intensity conditioning (RIC) and high-intensity conditioning (HIC) regimens as well as human leukocyte antigen (HLA)-matched and HLA-mismatched grafts.


METHODS
We retrospectively analyzed data of 87 ET patients from the European Group for Blood and Marrow Transplantation, Pediatric Registry for Stem Cell Transplantations, Asia Pacific Blood and Marrow Transplantation and MetaEICESS registries treated with allo-SCT. Fifty patients received RIC (group A) and 37 patients received HIC (group B). Twenty-four patients received HLA-mismatched grafts and 63 received HLA-matched grafts.


RESULTS
Median overall survival was 7.9 months [±1.24, 95% confidence interval (CI) 5.44-10.31] for group A and 4.4 months (±1.06, 95% CI 2.29-6.43) for group B patients (P = 1.3). Death of complications (DOC) occurred in 4 of 50 (0.08) and death of disease (DOD) in 33 of 50 (0.66) group A and in 16 of 37 (0.43) and 17 of 37 (0.46) group B patients, respectively. DOC incidence was decreased (P < 0.01) and DOD/relapse increased (P < 0.01) in group A compared with group B. HLA mismatch was not generally associated with graft-versus-Ewing tumor effect (GvETE).


CONCLUSIONS
There was no improvement of survival with RIC compared with HIC due to increased DOD/relapse incidence after RIC despite less DOC incidence. This implicates general absence of a clinically relevant GvETE with current protocols.
Department of Pediatrics and Wilhelm Sander Sarcoma Unit MRI, Pediatric Oncology Center, Technische Universität München.
U
U
Thiel
Department of Pediatrics and Wilhelm Sander Sarcoma Unit MRI, Pediatric Oncology Center, Technische Universität München.
A
A
Wawer
Institute for Medical Statistics and Epidemiology, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany.
P
P
Wolf
EBMT Data & Study Office, Hopital Saint-Antoine, Assistance Publique des Hôpitaux de Paris and UPMC Univ Paris 06, Paris, France.
M
M
Badoglio
Section of Pediatric Hematology & Oncology, University of Perugia, Perugia, Italy.
A
A
Santucci
Children's Hospital III, Department of Pediatrics, Johann Wolfgang Goethe University, Frankfurt.
T
T
Klingebiel
Children's Hospital III, Department of Pediatrics, Johann Wolfgang Goethe University, Frankfurt.
O
O
Basu
Department of Pediatric Oncology, Hematology and Clinical Immunology, Heinrich Heine University, Düsseldorf, Germany.
A
A
Borkhardt
Department of Pediatric Oncology, Hematology and Clinical Immunology, Heinrich Heine University, Düsseldorf, Germany.
H-J
HJ
Laws
Department of Promotion for Blood and Marrow Transplantation, Aichi Medical University, Aichi; APBMT Data Center, Nagoya University School of Medicine, Nagoya, Japan.
Y
Y
Kodera
APBMT Data Center, Nagoya University School of Medicine, Nagoya, Japan.
A
A
Yoshimi
Department of Pediatrics, St. Anna Kinderspital, Vienna, Austria.
C
C
Peters
Department of Pediatrics, St. Anna Kinderspital, Vienna, Austria.
R
R
Ladenstein
Department of Scienze Pediatriche Mediche e Chirurgiche, Ospedale S Orsola Malpighi, Bologna, Italy.
A
A
Pession
Department of Scienze Pediatriche Mediche e Chirurgiche, Ospedale S Orsola Malpighi, Bologna, Italy.
A
A
Prete
Department of Pediatrics, Medical University of Graz, Graz, Austria.
E-C
EC
Urban
Department of Pediatrics, Medical University of Graz, Graz, Austria.
W
W
Schwinger
Service de Transplantation Medullaire, CHU de Nancy Brabois, Vandoeuvre-les-Nancy, France.
P
P
Bordigoni
Service de Transplantation Medullaire, CHU de Nancy Brabois, Vandoeuvre-les-Nancy, France.
A
A
Salmon
Department of Pediatrics, Division of Pediatric Hematology-Oncology and Hematopoietic Stem Cell Transplantation and Cell Therapy Unit, Hospital Infantil Universitario Niño Jesus, Madrid, Spain.
M A
MA
Diaz
St. Petersburg State Medical Pavlov University, Ratsa Gorbacheva Memorial Children`s Institute, Department of Hematology and Transplantology, St. Petersburg, Russia.
B
B
Afanasyev
St. Petersburg State Medical Pavlov University, Ratsa Gorbacheva Memorial Children`s Institute, Department of Hematology and Transplantology, St. Petersburg, Russia.
I
I
Lisukov
St. Petersburg State Medical Pavlov University, Ratsa Gorbacheva Memorial Children`s Institute, Department of Hematology and Transplantology, St. Petersburg, Russia.
E
E
Morozova
Pediatric Hemato-Oncology Unit, Sheba Medical Center (affiliated to the Sackler Faculty of Medicine), Tel Hashomer, Israel.
A
A
Toren
Pediatric Hemato-Oncology Unit, Sheba Medical Center (affiliated to the Sackler Faculty of Medicine), Tel Hashomer, Israel.
B
B
Bielorai
Department of Hematology, Oncology and Transfusion Medicine Center, Vilnius University Hospital Santariskiu Clinics, Vilnius, Lithuania.
J
J
Korsakas
Stem Cell Transplantation and Cellular Therapy Unit, Pediatric Onco-Hematology Division, "Regina Margherita" Children's Hospital, Turin.
F
F
Fagioli
Department of Oncoematologia Pediatrica, Azienda Ospedaliero-Universitaria Meyer, Florence, Italy.
D
D
Caselli
Department of Internal Medicine I, University Hospital Carl Gustav Carus, Dresden.
G
G
Ehninger
Department of Pediatrics, University of Jena, Jena.
B
B
Gruhn
Department of Pediatric Hematology and Oncology, University Children's Hospital, Münster, Germany.
U
U
Dirksen
The Bone Marrow and Stem Cell Transplantation Program, King Hussein Cancer Center, Amman, Jordan.
F
F
Abdel-Rahman
Department of Istituto per la Ricerca e la Cura del Cancro, Turin, Italy.
M
M
Aglietta
Section of Pediatric Hematology & Oncology, University of Perugia, Perugia, Italy.
E
E
Mastrodicasa
Hospital de la Santa Creu i Sant Pau, Department of Pediatrics, Barcelona, Spain.
M
M
Torrent
Department of Hematology - Bone Marrow Transplantation Unit, Istituto Nazionale dei Tumori, University of Milano, Milan, Italy.
P
P
Corradini
Centre Hospitalier et Universitaire de Clermont-Ferrand, Service de Pédiatrie B et Unité Bioclinique de Thérapie Cellulaire, Clermont-Ferrand, France.
F
F
Demeocq
Department of UO Ematologia ed Oncologia Pediatrica, Istituto G Gaslini, Genova, Italy.
G
G
Dini
Department of Internal Medicine V, University of Heidelberg, Heidelberg.
P
P
Dreger
Children's Hospital, Department of Paediatric Stem Cell Transplantation, University of Würzburg, Würzburg, Germany.
M
M
Eyrich
Transplantation Centre, University Children's Hospital, Cracow, Poland.
J
J
Gozdzik
Department of Hematology, University Hospital, Poitiers, France.
F
F
Guilhot
Department of Hematology and Oncology, University of Regensburg, Regensburg.
E
E
Holler
Department of Pediatrics 5 (Oncology, Hematology, Immunology), Olga Hospital, Klinikum Stuttgart, Stuttgart, Germany.
E
E
Koscielniak
Hemo/Oncology, Department of Pediatrics, Hospital-University of Padova, Padova, Italy.
C
C
Messina
University Hospital of Innsbruck, Internal Medicine V, Department of Hematology and Oncology, Innsbruck, Austria.
D
D
Nachbaur
Department of Oncology, Haematology, and Respiratory Diseases, Policlinico di Modena, Modena.
R
R
Sabbatini
Department of U.S.C. Ematologia, Ospedali Riuniti, Bergamo, Italy.
E
E
Oldani
Department of Bone Marrow Transplantation, University Hospital of Essen, Essen, Germany.
H
H
Ottinger
Paediatric Oncology Unit, University of Geneva Children's Hospital, Geneva, Switzerland.
H
H
Ozsahin
Division of Clinical Hematology and BMT Unit, University Hospital Brussels, Brussels, Belgium.
R
R
Schots
Department of S. C. Divisione Oncologia Falck and S. C. Divisione Anatomia Patologica, Ospedale Niguarda Ca' Granda, Milan, Italy.
S
S
Siena
Bone marrow Transplant Unit, Department of Pediatric Hematology-Oncology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.
J
J
Stein
Bone Marrow Transplantation Unit, Department of Pediatrics, Comenius University Medical School, Bratislava, Slovak Republic.
S
S
Sufliarska
Institutions Erciyes Medical School, Department of Hematology and Oncology, Kapadokya BMT Center, Kayseri, Turkey.
A
A
Unal
Department of Pediatric Hematology, Oncology and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland.
M
M
Ussowicz
Department of Pediatric Hematology and Oncology, Hôpital Charles Nicolle, Rouen, France.
P
P
Schneider
Department of Pediatric Hematology and Oncology, University Hospital, Giessen, Germany.
W
W
Woessmann
Department of Pediatric Hematology and Oncology, University Children's Hospital, Münster, Germany.
H
H
Jürgens
Unit of Medical Oncology, Ospedale San Giuseppe, Milan, Italy.
M
M
Bregni
Department of Pediatrics and Wilhelm Sander Sarcoma Unit MRI, Pediatric Oncology Center, Technische Universität München. Electronic address: meta-eicess@lrz.tum.de.
S
S
Burdach
D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000401:mortality* / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012512:Sarcoma, Ewing / Q000401:mortality* / Q000628:therapy*; D033581:Stem Cell Transplantation; D015996:Survival Rate; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult