TITLE:
Low Dose Total Body Irradiation (600 cGy) as a Conditioning Regimen in Allogenic Hematopoietic Stem Cell Transplant in Children with Acute Lymphoblastic Leukemia
AUTHORS:
Alberto Olaya-Vargas, Martín Pérez-García, Nideshda Ramírez-Uribe, M. Angeles Del Campo-Martinez, Gerardo Lopez-Hernández, Montserrat Hernández-García, Jorge Amador-Zarco, Guadalupe Garcia-Vega, Yadira Melchor-Vidal, Marta Zapata-Tarres, Rocío Cárdenas-Cardos, Roberto Rivera-Luna
KEYWORDS:
Total Body Irradiation, Stem Cell Transplantation
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.7 No.8,
August
10,
2016
ABSTRACT: Total body
irradiation (TBI) is conditioning regimen in children with acute lymphoblastic
leukemia (ALL) with a very high risk of relapse or in those who have not
achieved remission and have relapsed and subsequently received allogenic
hematopoietic stem cell transplantation (HSCT). A retrospective evaluation of
33 ALL patients in full remission with an indication of HSCT was performed to
evaluate overall survival (OS) and event-free survival (EFS). The inclusion
criteria included a myeloablative conditioning regimen of TBI at a dose of 600
cGy. The observed OS at 5 years was 50%, and the EFS of 32% we observed
difference in the EFS stem cell origin; the peripheral blood (PB) 60%, and the
umbilical cord blood (UC) accounted for 40%. Overall, 45% had a documented
chimerism. The OS at 5 years from patients with chimeras was 75%, while those
without chimeras had an OS at 5 years of 25%. The mortality in the first 100
days was 24%. A total of 24.2% of children presented with acute graft versus-host
disease (GVHD), while 33% had chronic GVHD. Currently, there is no general
agreement among all international centers regarding the optimum TBI dose. Our
study reports an acceptable range of adverse events with a relatively low dose
of 600 cGy.