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首页> 外文期刊>Pediatric blood & cancer >Comparison of conditioning regimens for autologous stem cell transplantation in children with acute myeloid leukemia: A nationwide retrospective study in Japan
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Comparison of conditioning regimens for autologous stem cell transplantation in children with acute myeloid leukemia: A nationwide retrospective study in Japan

机译:急性髓白血病儿童自体干细胞移植调理方案的比较:日本全国回顾性研究

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Abstract Background Indications for hematopoietic stem cell transplantation (HSCT) have decreased with the improvement in chemotherapy for pediatric acute myeloid leukemia (AML) in the last decade. We conducted reevaluation of autologous HSCT (AHSCT) to compare myeloablative conditioning (MAC) regimens for pediatric AML without the need for consideration of toxicities caused by allogeneic immune reactions. Procedure This retrospective study analyzed the clinical outcomes of 220 children with AML who underwent consecutive AHSCT between 1989 and 2002 in Japan by the national prospective registry. The transplantation outcomes of various conditioning regimens were compared. Results The median follow‐up period of the survivors was 160 months. The clinical outcomes of busulfan + cyclophosphamide ± etoposide or busulfan + melphalan regimens were significantly superior compared with other busulfan‐based and total body irradiation‐based regimens (leukemia‐free survival [LFS]: 68% vs 42% and 55%, P ?=?0.001; overall survival [OS]: 74% vs 49% and 61%, P ??0.001). Multivariate analysis showed that busulfan + cyclophosphamide ± etoposide and busulfan + melphalan regimens were independent favorable factors for LFS (hazard ratio: 0.46; P ??0.001) and OS (hazard ratio: 0.40; P ??0.001) compared with the other busulfan‐based regimen, and both age 2 years or older and advanced stage at AHSCT were independent poor predictors for LFS and OS, simultaneously. Conclusion Busulfan + cyclophosphamide ± etoposide and busulfan + melphalan regimens exhibited superior antileukemic effects compared with other BU‐based myeloablative regimens.
机译:摘要造血干细胞移植(HSCT)的背景指示随着对去年儿科急性髓性白血病(AML)的改善而降低。我们进行了对自体HSCT(AHSCT)的重新评估,以比较小儿AML的髓鞘调节(MAC)方案,而无需考虑由同种异体免疫反应引起的毒性。该回顾性研究分析了220名儿童的临床结果,AML在1989年至2002年间在日本在日本在日本的前瞻性登记处接受了连续的AHSCT。比较了各种调理方案的移植结果。结果幸存者的中位随访期为160个月。与其他基于Busulfan的基于身体照射的中的临床苷或Busulfan + melphalan方案相比,Busulfan +环磷酰胺±eToposide或Busulfan + Melphalan方案的临床结果显着优越(无白血病存活[LFS]:68%与42%和55%,P? =?0.001;总存活[OS]:74%vs 49%和61%,p?<0.001)。多变量分析表明,Busulfan +环磷酰胺±etoposide和Busulfan + Melphalan方案是LFS(危害比率:0.46;p≤0.001)和OS(危险比:0.40;p≤0.001)的独立良好因素基于Busulfan的其他方案以及AHSCT的2岁或更老的年龄和高级阶段是LFS和OS的独立差的预测因子。结论Busulfan +环膦酰胺±eToposide和Busulfan + Melphalan方案表现出优异的抗血清症效应,与其他基于的基于Bu的Myeloablative方案相比。

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