Busulfan plus cyclophosphamide vs. total body irradiation plus cyclophosphamide for allogeneic hematopoietic stem cell transplantation in patients with acute T lymphoblastic leukemia: a large-scale propensity score-based study
Abstract Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is considered as a promising treatment option for T-cell acute lymphoblastic leukemia (T-ALL). However, the clinical prognosis outcomes of allo-HSCT in T-ALL patients following the two myeloablative conditioning regimens, total body irradiation plus cyclophosphamide (TBI-Cy) and busulfan plus cyclophosphamide (BuCy), have not yet been determined. We conducted a retrospective analysis on 222 patients with T-ALL. Of these, 83 received TBI-Cy and 139 received BuCy as conditioning regimens. The analysis was conducted after propensity score matching based on a large-scale data between 2012 and 2022. The TBI-Cy conditioning regimen resulted in significantly higher 2-year overall survival (OS) and progression-free survival (PFS) compared to the BuCy conditioning regimen (OS: 73.9% vs. 53.7%, p = 0.003; PFS: 58.6% vs.46.0%, p = 0.020). The improved survival outcomes may be attributed to the reduced cumulative incidence of relapse (CIR). The 2-year CIR was 35.7% in the TBI-Cy group, and 46.4% in the BuCy group (p = 0.036). Additionally, there was no significant difference in non-relapse mortality (NRM) between the two groups, with a 2-year NRM of 8.0% in the TBI-Cy group and 12.6% following the BuCy group (p = 0.315). Patients with extramedullary disease prior to allo-HSCT or were in no remission (NR) at allo-HSCT who received the TBI-Cy conditioning regimen showed improved survival outcomes compared to those who received the BuCy conditioning regimen. Multivariate analysis confirmed that the TBI-Cy conditioning regimen was an independent predictive factor for improved OS and PFS and reduced CIR. In conclusion, TBI-Cy conditioning regimen appears to be a safe and effective choice for allo-HSCT in T-ALL patients..
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Preprint| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
ResearchSquare.com - (2024) vom: 14. Apr. Zur Gesamtaufnahme - year:2024 |
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| Sprache: |
Englisch |
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| Beteiligte Personen: |
Xu, Yang [VerfasserIn] |
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| doi: |
10.21203/rs.3.rs-3850842/v1 |
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| 520 | |a Abstract Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is considered as a promising treatment option for T-cell acute lymphoblastic leukemia (T-ALL). However, the clinical prognosis outcomes of allo-HSCT in T-ALL patients following the two myeloablative conditioning regimens, total body irradiation plus cyclophosphamide (TBI-Cy) and busulfan plus cyclophosphamide (BuCy), have not yet been determined. We conducted a retrospective analysis on 222 patients with T-ALL. Of these, 83 received TBI-Cy and 139 received BuCy as conditioning regimens. The analysis was conducted after propensity score matching based on a large-scale data between 2012 and 2022. The TBI-Cy conditioning regimen resulted in significantly higher 2-year overall survival (OS) and progression-free survival (PFS) compared to the BuCy conditioning regimen (OS: 73.9% vs. 53.7%, p = 0.003; PFS: 58.6% vs.46.0%, p = 0.020). The improved survival outcomes may be attributed to the reduced cumulative incidence of relapse (CIR). The 2-year CIR was 35.7% in the TBI-Cy group, and 46.4% in the BuCy group (p = 0.036). Additionally, there was no significant difference in non-relapse mortality (NRM) between the two groups, with a 2-year NRM of 8.0% in the TBI-Cy group and 12.6% following the BuCy group (p = 0.315). Patients with extramedullary disease prior to allo-HSCT or were in no remission (NR) at allo-HSCT who received the TBI-Cy conditioning regimen showed improved survival outcomes compared to those who received the BuCy conditioning regimen. Multivariate analysis confirmed that the TBI-Cy conditioning regimen was an independent predictive factor for improved OS and PFS and reduced CIR. In conclusion, TBI-Cy conditioning regimen appears to be a safe and effective choice for allo-HSCT in T-ALL patients. | ||
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| 700 | 1 | |a Shen, Danya |e verfasserin |4 aut | |
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| 700 | 1 | |a Wu, Depei |e verfasserin |4 aut | |
| 700 | 1 | |a Hu, Shaoyan |e verfasserin |4 aut | |
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