Scientific article
Open access

Myeloablative conditioning for allo-HSCT in pediatric ALL: FTBI or chemotherapy? - A multicenter EBMT-PDWP study

Published inBone marrow transplantation, vol. 55, no. 8, p. 1540-1551
Publication date2020-08
First online date2020-03-17

Although most children with acute lymphoblastic leukemia (ALL) receive fractionated total body irradiation (FTBI) as myeloablative conditioning (MAC) for allogeneic hematopoietic stem cell transplantation (allo-HSCT), it is an important matter of debate if chemotherapy can effectively replace FTBI. To compare outcomes after FTBI versus chemotherapy-based conditioning (CC), we performed a retrospective EBMT registry study. Children aged 2-18 years after MAC for first allo-HSCT of bone marrow (BM) or peripheral blood stem cells (PBSC) from matched-related (MRD) or unrelated donors (UD) in first (CR1) or second remission (CR2) between 2000 and 2012 were included. Propensity score weighting was used to control pretreatment imbalances of the observed variables. 3.054 patients were analyzed. CR1 (1.498): median follow-up (FU) after FTBI (1.285) and CC (213) was 6.8 and 6.1 years. Survivals were not significantly different. CR2 (1.556): median FU after FTBI (1.345) and CC (211) was 6.2 years. Outcomes after FTBI were superior as compared with CC with regard to overall survival (OS), leukemia-free survival (LFS), relapse incidence (RI), and nonrelapse mortality (NRM). However, we must emphasize the preliminary character of the results of this retrospective "real-world-practice" study. These findings will be prospectively assessed in the ALL SCTped 2012 FORUM trial.

  • Child
  • Hematopoietic Stem Cell Transplantation
  • Humans
  • Leukemia, Myeloid, Acute
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy
  • Retrospective Studies
  • Survival Analysis
  • Transplantation Conditioning
  • Transplantation, Homologous
  • Whole-Body Irradiation
Citation (ISO format)
WILLASCH, Andre Manfred et al. Myeloablative conditioning for allo-HSCT in pediatric ALL: FTBI or chemotherapy? - A multicenter EBMT-PDWP study. In: Bone marrow transplantation, 2020, vol. 55, n° 8, p. 1540–1551. doi: 10.1038/s41409-020-0854-0
Main files (1)
Article (Published version)
ISSN of the journal0268-3369

Technical informations

Creation10/14/2021 12:33:00 PM
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