Titre :

Single Dose Daily Fractionated Is Not Inferior To Twice A Day Fractionated Total Body Irradiation Prior To Allogeneic Stem Cell Transplantation For Acute Leukemia: A Useful Practice Simplification Resulting From The Sarasin Study.

Auteur(s) :

Belkacemi, Yazid [Auteur]
Université Paris-Est Créteil Val-de-Marne - Paris 12 [UPEC UP12]
Labopin, Myriam [Auteur]
Université Pierre et Marie Curie - Paris 6 [UPMC]
Giebel, Sebastian [Auteur]
Loganadane, Gokoulakrichenane [Auteur]
Université Paris-Est Créteil Val-de-Marne - Paris 12 [UPEC UP12]
Miszczyk, Leszek [Auteur]
Michallet, Mauricette [Auteur]
Socie, Gerard [Auteur]
Schaap, Nicolaas [Auteur]
Cornelissen Jan, J [Auteur]
Yakoub-Agha, Ibrahim [Auteur]
Lille Inflammation Research International Center - U 995 [LIRIC]
Polge, Emmanuelle [Auteur]
Université Pierre et Marie Curie - Paris 6 [UPMC]
Mohty, Mohamad [Auteur]
Université Pierre et Marie Curie - Paris 6 [UPMC]
Gorin, Norbert-Claude [Auteur]
Université Pierre et Marie Curie - Paris 6 [UPMC]
Nagler, Arnon [Auteur]
Université Pierre et Marie Curie - Paris 6 [UPMC]

Titre de la revue :

International Journal of Radiation Oncology, Biology, Physics

Nom court de la revue :

Int. J. Radiat. Oncol. Biol. Phys.

Numéro :

102

Pagination :

515-526

Date de publication :

2018-11-01

ISSN :

1879-355X

Discipline(s) HAL :

Sciences du Vivant [q-bio]

Résumé en anglais : [en]

PURPOSE: Total-body irradiation (TBI) is a major constituent of myeloablative conditioning regimens. The standard technique consists of 12 Gy in 6 fractions over a period of 3 days. The Standard-fractionation compAred ...
Lire la suite >PURPOSE: Total-body irradiation (TBI) is a major constituent of myeloablative conditioning regimens. The standard technique consists of 12 Gy in 6 fractions over a period of 3 days. The Standard-fractionation compAred to one-daily fRaction total body irrAdiation prior to tranSplant In LEUkemia patieNts (SARASIN) study aimed to compare standard fractionation with once-daily fractionation before transplant in leukemia. METHODS AND MATERIALS: We retrospectively compared TBI regimens delivered in 2993 patients from the European Society for Blood and Marrow Transplantation database, who underwent transplantation between 2000 and 2014 for acute lymphoblastic leukemia (ALL, n = 1729) or acute myeloid leukemia (AML, n = 1264). TBI was delivered as either 12 Gy in 6 fractions (group 1, considered the reference group; 1362 ALL and 857 AML patients), 9 to 12 Gy in 2 fractions (group 2, 173 ALL and 256 AML patients), or 12 Gy in 3 to 4 fractions (group 3, 194 ALL and 151 AML patients). RESULTS: The median follow-up was 60 and 84 months in ALL and AML patients, respectively. At 5 years, the leukemia-free survival rate, overall survival rate, relapse incidence, and nonrelapse mortality rate were 46.6%, 50.4%, 28.8%, and 24.6%, respectively, in ALL patients and 46.6%, 48.9%, 29.7%, and 23.6%, respectively, in AML patients. In multivariate analyses, the outcomes of groups 2 and 3 were not statistically different from those in group 1. The cumulative incidence of secondary malignancies (SMs) was significantly higher in group 2 (7.2%; P < 10(-6) for group 2 vs group 1). However, group 2 was not associated with an increase in SMs when we considered non-T-cell-depleted transplant patients. CONCLUSIONS: We showed that the 12-Gy fractionated TBI dose delivered either in 2 fractions or in 1 fraction per day over a period of 3 to 4 days resulted in nonsignificant differences in disease control and survival. However, 1-day fractionation may be associated with a higher risk of mucositis and hemorrhagic cystitis. The absence of a significant difference in the SM incidence in the non-T-cell-depleted group should be interpreted with caution in the context of a retrospective study design. Our findings are important to consider for radiation therapy department organization. In-depth analyses of other nonlethal toxicities and late effects are required.Lire moins >

Langue :

Anglais

Audience :

Internationale

Vulgarisation :

Non

Établissement(s) :

Inserm
Université de Lille
CHU Lille

Collections :

• Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286

Équipe(s) de recherche :

Immunity, inflammation and fibrsis in auto and allo-reactivity

Date de dépôt :

2019-03-01T14:17:46Z
2024-01-30T13:54:00Z