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Low Dose Total Body Irradiation (600 cGy) as a Conditioning Regimen in Allogenic Hematopoietic Stem Cell Transplant in Children with Acute Lymphoblastic Leukemia

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Journal of Cancer Therapy 2016年第8期7卷 586-592页

作者： Alberto Olaya-Vargas Martín Pérez-García Nideshda Ramírez-Uribe M. Angeles Del Campo-Martinez Gerardo Lopez-Hernández Montserrat Hernández-García Jorge Amador-Zarco Guadalupe Garcia-Vega Yadira Melchor-Vidal marta zapata-tarres Rocío Cárdenas-Cardos Roberto Rivera-Luna Hematopoietic Stem Cell Transplant Unit (HSCTU) from Pediatric National Institute (INP) Mexico City Mexico Pediatric Bone Marrow Transplant Program at the HSCTU INP Mexico City Mexico Pediatric Bone Marrow Transplant Program at the HSCTU-HITO Hospital Mexico City Mexico Radiotherapy Department INP Mexico City Mexico Pediatric Bone Marrow Transplant Program at the HSCTU-ABC Medical Center Mexico City Mexico Department of Pediatric Oncology from the INP Mexico City Mexico Division of Pediatric Hem/Oncology from the INP Mexico City Mexico

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.

关键词： Total Body Irradiation Stem Cell Transplantation

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ADE as Induction Therapy Results in Treatment of Children with Non-M3 High-Risk Acute Myeloid Leukemia, an Extrapolable Achievement in Developing Countries

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Journal of Cancer Therapy 2016年第3期7卷 197-202页

作者： marta zapata-Tarrés Rocío Cárdenas-Cardós Liliana Velasco-Hidalgo Martín Pérez-García Alberto Olaya-Vargas Daniela Cárdenas-Pedraza Roberto Rivera-Luna Oncology Department Instituto Nacional de Pediatría México City México Hematopoietic Stem Cell Transplantation Instituto Nacional de Pediatría México City México Division of Hem-Oncology Instituto Nacional de Pediatría México City México

Background: In Mexico, AML survival is referred in 30%. Our aim was to evaluate results with ADE protocol as induction treatment in children with non-M3 AML in a public Mexican institution. Method: We included patients with AML in a single institution between 2005 and 2013. All non-M3-AML patients received ADE as induction therapy (cytarabine 100 mg/m2 in continuous infusion from day 1 to 7, daunorrubicin 30 mg/m2 days 1, 3, 5 and etoposide 100 mg/m2 over days 1 to 5). Patients received antibiotic prophylaxis and strict scheduled appointments to assure adherence and prevent avoidable emergencies. Main Results: Eighteen patients were included. Median age was 106 months. One patient died at diagnosis so 17 were eligible for induction results analysis;eleven needed two cycles and six patients three. Remission rate was 100%. Analyzing non-M3 patients overall survival was 80.2% at 100 months. No fatal complications were observed. Stratifying by number of cycles we observe that patients receiving one ADE cycle had a 0% overall survival at short follow up, with 2 ADE cycles 80% at 100 months and with 3 cycles 100% at 60 months. Conclusion: ADE induction therapy showed improved results in overall survival compared with other standard regimens. Following the protocol we obtained 100% remission. This is an important achievement in our population. Our focus must be to ameliorate maintenance final results. These results should be reproduced in other hospitals in Mexico and other countries.

关键词： Acute Myeloid Leukemia Children Treatment ADE

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