title: Impact on long-term OS of conditioning regimen in allogeneic BMT for children with AML in first CR: TBI+CY versus BU+CY: a report from the Société Française de Greffe de Moelle et de Thérapie Cellulaire.
abstract: Allogeneic hematopoietic SCT (HSCT) appears to be an efficient tool to cure high-risk AML in first CR but the choice between BU-based or TBI-based conditioning regimens still remains controversial. In order to analyze the impact of conditioning regimen on long-term survival, we conducted a retrospective analysis from French registry data including all consecutive patients under 18 years old (n=226) from 1980 to 2004 transplanted for AML in CR1 from sibling (n=142) or matched unrelated donors and given either TBI-1200 cGy and CY 120 mg/kg (TBI-Cy, n=84) or BU 16 mg/kg and CY 200 mg/kg (BuCy200, n=142). Patient subgroups were comparable for all criteria except for median age at diagnosis and HSCT and for donor type. Both 5-year OS and disease-free survival (DFS) were significantly better in BuCy200 group (P=0.02 and 0.005, respectively). In multivariate analysis, both HLA matching and BuCy200 appeared as good prognostic factors for treatment-related mortality and DFS. Grade 2-4 acute GvHD and chronic GvHD rates were statistically higher in TBI-Cy group than in Bu-Cy200 one with a RR at 2 (P=0.002). In total, Bu-Cy200 conditioning regimen gives better outcome compared with TBI-Cy irrespective of the stem cell source and the donor type.
authors: Pediatric Hematology Department, Jeanne de Flandre Hospital, CHRU Lille, Lille, France.
authors: E
authors: E
authors: de Berranger
authors: EA 2694, Faculté de Médecine, Lille, France.
authors: A
authors: A
authors: Cousien
authors: Pediatric Hematology and Oncology Department, Trousseau Hospital, Assistance Publique-Hopitaux de Paris, Paris, France.
authors: A
authors: A
authors: Petit
authors: Hematology Department, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
authors: R
authors: R
authors: Peffault de Latour
authors: Pediatric Hematology Department, Timone Hospital, Marseille, France.
authors: C
authors: C
authors: Galambrun
authors: Pediatric Hematology and Oncology Unit, IHOP, Lyon, France.
authors: Y
authors: Y
authors: Bertrand
authors: Pediatric Hematology and Oncology Department, CHU Nancy, Vandoeuvre-les-Nancy, France.
authors: A
authors: A
authors: Salmon
authors: 1] Centre Hospitalier et Universitaire (CHU) de Nantes, Service d'Onco-Hématologie Pédiatrique, Nantes, France [2] Université de Nantes, Faculté de Médecine, Nantes, France.
authors: F
authors: F
authors: Rialland
authors: HSCT department, CHU Besançon, Besançon, France.
authors: P-S
authors: PS
authors: Rohrlich
authors: Pediatric Hematology and Oncology Unit, CHU Rouen, Rouen, France.
authors: J-P
authors: JP
authors: Vannier
authors: Pediatric Hematology and Oncology Unit, CHU Strasbourg, Strasbourg, France.
authors: P
authors: P
authors: Lutz
authors: Pediatric Hematology Department, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
authors: K
authors: K
authors: Yakouben
authors: EA 2694, Faculté de Médecine, Lille, France.
authors: A
authors: A
authors: Duhamel
authors: Pediatric Hematology Department, Jeanne de Flandre Hospital, CHRU Lille, Lille, France.
authors: B
authors: B
authors: Bruno
authors: Pediatric Hematology Department, Timone Hospital, Marseille, France.
authors: G
authors: G
authors: Michel
authors: 1] Pediatric Hematology Department, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France [2] INSERM 1149, Paris Diderot University, Paris, France.
authors: J-H
authors: JH
authors: Dalle
mesh_terms: D000293:Adolescent; D001835:Body Weight; D002066:Busulfan / Q000737:chemistry; D002648:Child; D002675:Child, Preschool; D003520:Cyclophosphamide / Q000627:therapeutic use; D005260:Female; D005602:France; D006086:Graft vs Host Disease; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007223:Infant; D053208:Kaplan-Meier Estimate; D015470:Leukemia, Myeloid, Acute / Q000401:mortality / Q000628:therapy*; D008297:Male; D015999:Multivariate Analysis; D012008:Recurrence; D012042:Registries; D012189:Retrospective Studies; D035781:Siblings; D012955:Societies, Medical; D014019:Tissue Donors; D019172:Transplantation Conditioning / Q000379:methods*; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D014916:Whole-Body Irradiation
chemical_list: D003520:Cyclophosphamide; D002066:Busulfan