INFLUENCE OF THE FRACTIONATION OF TOTAL-BODY IRRADIATION ON COMPLICATIONS AND RELAPSE RATE FOR CHRONIC MYELOGENOUS LEUKEMIA

被引:57
作者
SOCIE, G
DEVERGIE, A
GIRINSKY, T
REIFFERS, J
VERNANT, JP
LEBOURGEOIS, JP
HERVE, P
GUYOTAT, D
MARANINCHI, D
RIO, B
MICHALLET, M
JOUET, JP
MILPIED, N
LEBLOND, V
PICO, J
ATTAL, M
BELANGER, C
GLUCKMAN, E
COSSET, JM
机构
[1] INST GUSTAVE ROUSSY,INSERM,U247,F-94805 VILLEJUIF,FRANCE
[2] HOP ST LOUIS,UNITE FONCTIONELLE GREFFE MOELLE,F-75475 PARIS 10,FRANCE
[3] HOP HENRI MONDOR,F-94010 CRETEIL,FRANCE
[4] INST J PAOLI I CALMETTES,F-13009 MARSEILLE,FRANCE
[5] HOP EDOUARD HERRIOT,F-69374 LYONS 08,FRANCE
[6] HOP HOTEL DIEU,F-44035 NANTES,FRANCE
[7] HOP HOTEL DIEU,F-75181 PARIS 04,FRANCE
[8] HOP COCHIN,F-75674 PARIS 14,FRANCE
[9] HOP PURPAN,TOULOUSE,FRANCE
[10] HOP HAUT LEVEQUE,PESSAC,FRANCE
[11] CTR TRANSFUS,BESANCON,FRANCE
[12] HOP TRONCHE,GRENOBLE,FRANCE
[13] HOP HURRIEZ,LILLE,FRANCE
[14] HOP LA PITIE SALPETRIERE,PARIS,FRANCE
[15] HOP PURPAN,TOULOUSE,FRANCE
来源
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS | 1991年 / 20卷 / 03期
关键词
TBI FRACTIONATION; INTERSTITIAL PNEUMONITIS; RELAPSE; BONE MARROW TRANSPLANTATION;
D O I
10.1016/0360-3016(91)90048-9
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
One hundred eighty patients with chronic myelogenous leukemia, who received an unmanipulated marrow graft from an Human Leucocyte Antigen identical sibling donor, were reported to our group (G.E.G.M.O.) by 21 transplant teams. All were grafted after a total body irradiation-cytoxan conditioning regimen. Of these 180 patients, 126 were non-randomly assigned to single dose total body irradiation (STBI group) and, 54 to fractionated total body irradiation (FTBI group). With a median follow-up of 40 months, there is no statistically significant difference in the 5-year survival rate between the two groups (51% for the whole population). In a first step we demonstrate by multivariate analysis that total body irradiation fractionation can dramatically decrease the incidence of interstitial pneumonitis. However, a multivariate analysis of potent risk factors for relapse post-transplant strongly suggests that TBI fractionation is also linked to an increased relapse rate. So, a sparing effect of fractionation for lung tissue could be offset by a less effective leukemic stem cell kill. Those results from a retrospective, non-randomized, multi-institutional study clearly need additional clinical data, ideally from a randomized study.
引用
收藏
页码:397 / 404
页数:8
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