Hematopoietic cell transplant outcomes after myeloablative conditioning with fludarabine, busulfan, low‐dose total body irradiation, and rabbit antithymocyte globulin

2020 ◽  
Vol 34 (9) ◽  
Author(s):  
Samar Ousia ◽  
Amit Kalra ◽  
Tyler S. Williamson ◽  
Nicole Prokopishyn ◽  
Poonam Dharmani‐Khan ◽  
...  
Keyword(s):  
Total Body Irradiation ◽  
Antithymocyte Globulin ◽  
Low Dose ◽  
Hematopoietic Cell ◽  
Cell Transplant ◽  
Hematopoietic Cell Transplant ◽  
Myeloablative Conditioning ◽  
Transplant Outcomes ◽  
Rabbit Antithymocyte Globulin ◽  
Total Body

scholarly journals Cumulative incidence of subsequent malignancy after allo-HCT conditioned with or without low-dose total body irradiation

2021 ◽  
Author(s):  
Lina Nunez ◽  
Tasnima Abedin ◽  
Syed Ali Naqvi ◽  
Hua Shen ◽  
Ahsan Chaudhry ◽  
...  
Keyword(s):  
Total Body Irradiation ◽  
Cumulative Incidence ◽  
Low Dose ◽  
High Dose ◽  
Cell Transplant ◽  
Hematopoietic Cell Transplant ◽  
Entire Cohort ◽  
Increase Risk ◽  
Significant Burden ◽  
Total Body

Subsequent malignancies (SM) present a significant burden of morbidity and are a common cause of late mortality in survivors of allogeneic HCT (hematopoietic cell transplant). Previous studies have described total body irradiation (TBI) as a risk factor for the development of SM in allo-HCT survivors. However, most studies of the association between TBI and SM have examined high dose TBI regimes (typically ≥600cGy) and thus little is known about the association between low dose TBI regimens and risk of SM. Thus, we set out to compare the cumulative incidence of SM in Albertan patients who received busulfan/fludarabine alone versus busulfan/fludarabine plus 400 cGy TBI. Of 674 included patients, 49 patients developed a total of 56 malignancies at a median of 5.9 years post-transplant. The cumulative incidence of SM at 15 years post-HCT in the entire cohort was 11.5% (95% CI 8.5-15.6%): 13.4% (95% CI 9.1-19.3%) in the no-TBI group and 10.8% (95% CI 6.6-17.4%) in the TBI group. In the multivariable model, TBI was not associated with SM, while number of pre-HCT cycles of chemotherapy was. The standardized incidence ratio for the entire cohort, as compared to the age, sex and calendar-year matched general population was 1.74. Allo-HCT conditioning that includes low dose TBI does not appear to increase risk of SM as compared to chemotherapy-alone conditioning.

Sign in / Sign up

Export Citation Format

Share Document