A Comparison of Cyclophosphamide and Total Body Irradiation with Etoposide and Total Body Irradiation as Conditioning Regimens for Patients Undergoing.

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Presentation transcript:

A Comparison of Cyclophosphamide and Total Body Irradiation with Etoposide and Total Body Irradiation as Conditioning Regimens for Patients Undergoing Sibling Allografting for Acute Lymphoblastic Leukemia in First or Second Complete Remission David I. Marks, Stephen J. Forman, Karl G. Blume, Waleska S. Pérez, Daniel J. Weisdorf, Armand Keating, Robert Peter Gale, Mitchell S. Cairo, Edward A. Copelan, John T. Horan, Hillard M. Lazarus, Mark R. Litzow, Philip L. McCarthy, Kirk R. Schultz, David D. Smith, Michael E. Trigg, Mei-Jie Zhang, Mary M. Horowitz Biology of Blood and Marrow Transplantation Volume 12, Issue 4, Pages 438-453 (April 2006) DOI: 10.1016/j.bbmt.2005.12.029 Copyright © 2006 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 1 Cumulative incidence of TRM after HLA-identical sibling transplantations for ALL in first (A) or second (B) complete remission, according to the pretransplantation conditioning regimen (pointwise P value at 5 years for CR1 patients: etoposide-TBI <13 Gy versus Cy-TBI ≥13 Gy, P = .49; etoposide-TBI <13 Gy versus Cy-TBI <13 Gy, P = .17; etoposide-TBI <13 Gy versus etoposide-TBI ≥13 Gy, P = .14; Cy-TBI ≥13 Gy versus Cy-TBI <13 Gy, P = .40; Cy-TBI ≥13 Gy versus etoposide-TBI ≥13 Gy, P = .33; Cy-TBI <13 Gy versus etoposide-TBI ≥13 Gy, P = .81; pointwise P value at 5 years for CR2 patients: etoposide-TBI <13 Gy versus Cy-TBI ≥13 Gy, P = .21; etoposide-TBI <13 Gy versus Cy-TBI <13 Gy, P = .14; etoposide-TBI <13 Gy versus etoposide-TBI ≥13 Gy, P = .79; Cy-TBI ≥13 Gy versus Cy-TBI <13 Gy, P = .98; Cy-TBI ≥13 Gy versus etoposide-TBI ≥13 Gy, P = .30; Cy-TBI <13 Gy versus etoposide-TBI ≥13 Gy, P = .22). Vp16 indicates etoposide. Biology of Blood and Marrow Transplantation 2006 12, 438-453DOI: (10.1016/j.bbmt.2005.12.029) Copyright © 2006 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 2 Cumulative incidence of relapse after HLA-identical sibling transplantations for ALL in first (A) or second (B) complete remission, according to the pretransplantation conditioning regimen (pointwise P value at 5 years for CR1 patients: etoposide-TBI versus Cy-TBI <13 Gy, P = .23; etoposide-TBI versus Cy-TBI ≥13 Gy, P = .78; Cy-TBI <13 Gy versus Cy-TBI ≥13 Gy, P = .60; pointwise P value at 5 years for CR2 patients: etoposide-TBI versus Cy-TBI <13 Gy, P = .22; etoposide-TBI versus Cy-TBI ≥13 Gy, P = .033; Cy-TBI <13 Gy versus Cy-TBI ≥13 Gy, P = .001). Vp16 indicates etoposide. Biology of Blood and Marrow Transplantation 2006 12, 438-453DOI: (10.1016/j.bbmt.2005.12.029) Copyright © 2006 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 3 Adjusted probability (derived from multivariate regression models) of LFS after HLA-identical sibling transplantations for ALL in first (A) or second (B) complete remission, according to the pretransplantation conditioning regimen (pointwise P value at 5 years for CR1 patients: etoposide-TBI versus Cy-TBI <13 Gy, P = .21; etoposide-TBI versus Cy-TBI ≥13 Gy, P = .17; Cy-TBI <13 Gy versus Cy-TBI ≥13 Gy, P = .59; pointwise P value at 5 years for CR2 patients: etoposide-TBI versus Cy-TBI <13 Gy, P = .002; etoposide-TBI versus Cy-TBI ≥13 Gy, P = .23; Cy-TBI <13 Gy versus Cy-TBI ≥13 Gy, P < .001). Vp16 indicates etoposide. Biology of Blood and Marrow Transplantation 2006 12, 438-453DOI: (10.1016/j.bbmt.2005.12.029) Copyright © 2006 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 4 Adjusted probability (derived for multivariate regression models) of overall survival after HLA-identical sibling transplantations for ALL in first (A) or second (B) complete remission, according to the pretransplantation conditioning regimen (pointwise P value at 5 years for CR1 patients: etoposide-TBI versus Cy-TBI <13 Gy, P = .18; etoposide-TBI versus Cy-TBI ≥13 Gy, P = .47; Cy-TBI <13 Gy versus Cy-TBI ≥13 Gy, P = .87; pointwise P value at 5 years for CR2 patients: etoposide-TBI versus Cy-TBI <13 Gy, P = .029; etoposide-TBI versus Cy-TBI ≥13 Gy, P = .012; Cy-TBI <13 Gy versus Cy-TBI ≥13 Gy, P < .001). Vp16 indicates etoposide. Biology of Blood and Marrow Transplantation 2006 12, 438-453DOI: (10.1016/j.bbmt.2005.12.029) Copyright © 2006 American Society for Blood and Marrow Transplantation Terms and Conditions