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The Outcome of Allogeneic Hematopoietic Stem Cell Transplants Without Total Body Irradiation in Pediatric Patients With Acute Lymphoblastic Leukemia: Single Centre Experience

Hamidieh, Amir Ali MD; Kargar, Mona PharmD; Jahani, Mohammad MD; Alimoghaddam, Kamran MD; Bahar, Babak MD; Mousavi, Seyed Asadollah MD; Iravani, Masoud MD; Jalali, Arash PhD; Jalili, Mahdi MD; Ghavamzadeh, Ardeshir MD

Journal of Pediatric Hematology/Oncology:
doi: 10.1097/MPH.0b013e31824435a1
Original Articles
Abstract

The most widely accepted conditioning regimen to allogeneic hematopoietic stem cell transplantation consists of total body irradiation, especially in patients affected by acute lymphoblastic leukemia (ALL). In this retrospective study, we report our experience on hematopoietic stem cell transplantation in 44 pediatric patients with acute lymphoblastic leukemia using a non-radiation–based conditioning regimen (busulfan/cyclophosphamide). Median age at transplantation was 12.5 years (range, 4 to 14 y). 39 out of 44 patients received transplants in complete remission. At a median follow-up of 390 days, the probabilities of 3-year disease-free survival and overall survival were 50% and 68%, respectively. Disease status of hematopoietic stem cell transplantation was the only significant variable affecting the overall survival. Acute and chronic graft-versus-host disease occurred in 23 (64%) and 12(18%) patients, respectively. Relapse was significantly higher among patients transplanted in advanced disease status. The results of the study indicate that non-radiation–based preparative regimens can be used in pediatric patients with ALL. However, well-designed comparative trials are needed to better clarify the difference between radiation and non-radiation–based conditioning regimens in pediatric ALL.

Author Information

*Hematology-Oncology and Stem Cell Transplantation Research Center

Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran

The authors declare no conflict of interest.

Reprints: Mahdi Jalili, MD, Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Shariati Hospital, Karegar Ave. P.C. 14114, Tehran, Iran (e-mail: m_jalili@farabi.tums.ac.ir).

Received December 11, 2010

Accepted November 4, 2011

Copyright © 2012 Wolters Kluwer Health, Inc. All rights reserved.