Effect of once-a-day fractionated total body irradiation on the risk of relapse after non-T-cell-depleted HLA-matched sibling transplantation

Radiat Med. 2007 Oct;25(8):407-10. doi: 10.1007/s11604-007-0158-y. Epub 2007 Oct 26.

Abstract

Purpose: The aim of this study was to assess the impact of fractionated total body irradiation (F-TBI) on treatment-related mortality (TRM) and relapse in patients who received a non-T-cell-depleted allogeneic stem cell transplantation (ASCT) for hematological malignancies.

Materials and methods: Between March 2003 and December 2004, a total of 24 patients with HLA-identical sibling donors entered this study and received three doses of 3.33 Gy F-TBI separated by 24 h and cyclophosphamide or etoposide.

Results: At a median follow-up of 37 months (range 29-47 months), 4 of the 24 patients (16.6%) died of TRM. Relapse occurred in 10 patients at a median of 9 months (range 2-18 months). Overall, 13 of 24 patients (54%) died. Relapse was the most common cause of death (9/13). The 2-year actuarial survival rate was 46% (+/-11%).

Conclusion: In our experience, ASCT conditioned with F-TBI was associated with low TRM but a high early relapse rate in patients with hematological malignancies.

MeSH terms

  • Adolescent
  • Adult
  • Bone Marrow Transplantation / adverse effects*
  • Child
  • Female
  • HLA Antigens / immunology*
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Humans
  • Leukemia / mortality
  • Leukemia / radiotherapy*
  • Leukemia / surgery
  • Lymphoma, Non-Hodgkin / mortality
  • Lymphoma, Non-Hodgkin / radiotherapy*
  • Lymphoma, Non-Hodgkin / surgery
  • Male
  • Recurrence
  • Siblings
  • Survival Rate
  • T-Lymphocytes / immunology
  • Transplantation, Homologous
  • Whole-Body Irradiation / adverse effects*
  • Whole-Body Irradiation / methods

Substances

  • HLA Antigens