Occurrence of long-term effects after hematopoietic stem cell transplantation in children affected by acute leukemia receiving either busulfan or total body irradiation: results of an AIEOP (Associazione Italiana Ematologia Oncologia Pediatrica) retrospective study.


Journal

Bone marrow transplantation
ISSN: 1476-5365
Titre abrégé: Bone Marrow Transplant
Pays: England
ID NLM: 8702459

Informations de publication

Date de publication:
10 2020
Historique:
received: 19 09 2019
accepted: 20 01 2020
revised: 13 12 2019
pubmed: 31 1 2020
medline: 25 5 2021
entrez: 31 1 2020
Statut: ppublish

Résumé

Patients given allogeneic hematopoietic stem cell transplantation (alloHSCT) present an increased incidence of long-term toxicities that can be attributed to the preparative regimen. We retrospectively analyzed in a population of 670 children receiving allo-HSCT for acute leukemia the occurrence of different late effects in function of the choice made between total body irradiation (TBI) and busulfan, as part of the preparative regimen. In univariable analysis, we found that patients treated with TBI developed cataract in 24% of the cases compared with 4% in patients treated with BU (p = 0.0001) and that the incidence of secondary malignant neoplasia (SMN) was higher in patients treated with TBI (18%) as compared with those prepared to the allograft with a Bu-based regimen (0%) (p = 0.019). Conditioning regimen did not show a statistically significant correlation with the occurrence of all the other investigated late effects. In multivariable analysis, TBI remained associated with the occurrence of cataracts (Relative Risk: 0.33 p = 0.012) and secondary malignancies (Relative Risk 3.96 × 10e-6 p < 0.001); however, other variables, as GvHD and disease type, were also correlated with these long-term sequels, indicating that in our study population the preparative regimen is not the only factor influencing the incidence of these complications.

Identifiants

pubmed: 31996791
doi: 10.1038/s41409-020-0806-8
pii: 10.1038/s41409-020-0806-8
doi:

Substances chimiques

Cyclophosphamide 8N3DW7272P
Busulfan G1LN9045DK

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1918-1927

Commentaires et corrections

Type : CommentIn

Références

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Auteurs

Francesco Saglio (F)

Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, Regina Margherita Children's Hospital, Torino, Italy. francesco.saglio@unito.it.
University of Turin, Turin, Italy. francesco.saglio@unito.it.

Marco Zecca (M)

Pediatric Hematology/Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.

Daria Pagliara (D)

Department of Pediatric Hematology and Oncology, IRCCS, Ospedale Bambino Gesù, Rome, Italy.

Giovanna Giorgiani (G)

Pediatric Hematology/Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.

Adriana Balduzzi (A)

Bone Marrow Transplantation Unit, Pediatric Department of Milano-Bicocca University, Monza e Brianza per il Bambino e la sua Mamma Foundation, Monza, Italy.

Elisabetta Calore (E)

Pediatric Hematology-Oncology Unit, Department of Women's and Children's Health, Azienda Ospedaliera-University of Padova, Padova, Italy.

Claudio Favre (C)

Transplantation Unit, Department of Pediatric Oncology, Meyer Children's Hospital, Florence, Italy.

Maura Faraci (M)

Hematopoietic Stem Cell Unit, Department of Hematology-Oncology, IRCSS-Istituto G. Gaslini, Genova, Italy.

Arcangelo Prete (A)

Oncology, Hematology and Hematopoietic Stem Cell Transplant Program, U.O. Pediatrics- S, Orsola-Malpighi University of Bologna, Bologna, Italy.

Francesco Paolo Tambaro (FP)

Department of Hemato-Oncology, Santobono-Pausilipon Hospital, Bone Marrow Transplant Unit, Napoli, Italy.

Paola Quarello (P)

Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, Regina Margherita Children's Hospital, Torino, Italy.
University of Turin, Turin, Italy.

Franco Locatelli (F)

Department of Pediatric Hematology and Oncology, IRCCS, Ospedale Bambino Gesù, Rome, Italy.
Sapienza University of Rome, Rome, Italy.

Franca Fagioli (F)

Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, Regina Margherita Children's Hospital, Torino, Italy.
University of Turin, Turin, Italy.

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