Abstract
Total body irradiation (TBI) is conditioning regimen in children with acute lymphoblastic leukemia (ALL) with a very high risk of relapse or in those who have not achieved remission and have relapsed and subsequently received allogenic hematopoietic stem cell transplantation (HSCT). A retrospective evaluation of 33 ALL patients in full remission with an indication of HSCT was performed to evaluate overall survival (OS) and event-free survival (EFS). The inclusion criteria included a myeloablative conditioning regimen of TBI at a dose of 600 cGy. The observed OS at 5 years was 50%, and the EFS of 32% we observed difference in the EFS stem cell origin; the peripheral blood (PB) 60%, and the umbilical cord blood (UC) accounted for 40%. Overall, 45% had a documented chimerism. The OS at 5 years from patients with chimeras was 75%, while those without chimeras had an OS at 5 years of 25%. The mortality in the first 100 days was 24%. A total of 24.2% of children presented with acute graft versus-host disease (GVHD), while 33% had chronic GVHD. Currently, there is no general agreement among all international centers regarding the optimum TBI dose. Our study reports an acceptable range of adverse events with a relatively low dose of 600 cGy.
Highlights
Acute lymphoblastic leukemia (ALL) is the most common malignancy of childhood cancer in Mexico [1]-[4]
Despite the current knowledge in the biology of this disease and modern chemotherapy treatments, a number of children will eventually have to submit to hematopoietic stem cell transplantation (HSCT) [1]
The importance of HSCT resides in the conditioning regimen used, as well as in the desired effect of the graft versus leukemia, which maintains these patients under remission without the need of maintenance chemotherapy
Summary
Acute lymphoblastic leukemia (ALL) is the most common malignancy of childhood cancer in Mexico [1]-[4]. The 5-year overall survival (OS) for ALL is reported to be 75% or more [1] [5]-[9] When these patients relapse, during treatment with conventional chemotherapy regimens, the rate of survival diminishes significantly [10]-[12]. The importance of HSCT resides in the conditioning regimen used, as well as in the desired effect of the graft versus leukemia, which maintains these patients under remission without the need of maintenance chemotherapy. The purpose of the current work was to report the experience of a National Institute of Health at Mexico City with 33 consecutive pediatric ALL patients in complete remission and who had to submit to HSCT, using a myeloablative conditioning regimen including TBI at a dose of 600 cGy plus chemotherapy
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
