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Efficacy of Total‐Body Irradiation‐based Intensified Myeloablative Regimens for Acute Leukemia—An International Collaborative Study
Arai, Yasuyuki Brazauskas, Ruta He, Naya Al-Homsi, A. Samer Chhabra, Saurabh Battiwalla, Minoo Yanada, Masamitsu Steinberg, Amir Diaz Perez, Miguel Angel Hong, Sanghee
Arai, Yasuyuki
Brazauskas, Ruta
He, Naya
Al-Homsi, A. Samer
Chhabra, Saurabh
Battiwalla, Minoo
Yanada, Masamitsu
Steinberg, Amir
Diaz Perez, Miguel Angel
Hong, Sanghee
Author
Arai, Yasuyuki
Brazauskas, Ruta
He, Naya
Al-Homsi, A. Samer
Chhabra, Saurabh
Battiwalla, Minoo
Yanada, Masamitsu
Steinberg, Amir
Diaz Perez, Miguel Angel
Hong, Sanghee
Kanda, Junya
Bashey, Asad
Frangoul, Haydar A.
Badawy, Sherif M.
Verdonck, Leo F.
Lazarus, Hillard M.
Yared, Jean A.
Hashem, Hasan
Sharma, Akshay
Aljurf, Mahmoud
Dias, Ajoy L.
Abid, Muhammad Bilal
Wirk, Baldeep
Freytes, C�sar O.
Zeidan, Amer M.
Gergis, Usama
Beitinjaneh, Amer
Askar, Medhat
Pu, Jeffrey J.
Lehmann, Leslie E.
Rangarajan, Hemalatha G.
Wood, William A.
Hashmi, Shahrukh
Yano, Shingo
Kako, Shinichi
Ozawa, Yukiyasu
Doki, Noriko
Kanda, Yoshinobu
Fukuda, Takahiro
Katayama, Yuta
Ichinohe, Tatsuo
Tanaka, Junji
Teshima, Takanori
Okamoto, Shinichiro
Atsuta, Yoshiko
Saber, Wael
Brazauskas, Ruta
He, Naya
Al-Homsi, A. Samer
Chhabra, Saurabh
Battiwalla, Minoo
Yanada, Masamitsu
Steinberg, Amir
Diaz Perez, Miguel Angel
Hong, Sanghee
Kanda, Junya
Bashey, Asad
Frangoul, Haydar A.
Badawy, Sherif M.
Verdonck, Leo F.
Lazarus, Hillard M.
Yared, Jean A.
Hashem, Hasan
Sharma, Akshay
Aljurf, Mahmoud
Dias, Ajoy L.
Abid, Muhammad Bilal
Wirk, Baldeep
Freytes, C�sar O.
Zeidan, Amer M.
Gergis, Usama
Beitinjaneh, Amer
Askar, Medhat
Pu, Jeffrey J.
Lehmann, Leslie E.
Rangarajan, Hemalatha G.
Wood, William A.
Hashmi, Shahrukh
Yano, Shingo
Kako, Shinichi
Ozawa, Yukiyasu
Doki, Noriko
Kanda, Yoshinobu
Fukuda, Takahiro
Katayama, Yuta
Ichinohe, Tatsuo
Tanaka, Junji
Teshima, Takanori
Okamoto, Shinichiro
Atsuta, Yoshiko
Saber, Wael
Supervisor
Department
Computer Vision
Embargo End Date
Type
Journal article
Date
2025
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Language
English
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Abstract
Background
In this study, we compared outcomes of intensified myeloablative conditioning regimens using large registry data from Japan (Japanese Society for Transplantation and Cellular Therapy) and the United States (Center for International Blood and Marrow Transplant Research).
Methods
Adult patients who underwent their first myeloablative allogeneic hematopoietic stem cell transplantation (HSCT) for acute leukemia in remission between 2010 and 2018 using conditioning regimens of cyclophosphamide plus total-body irradiation (CY/TBI), CY/TBI+cytarabine (AraC), or CY/TBI+etoposide (VP16) were included.
Results
The acute myeloid leukemia (AML) cohort (N = 480, 38.8%) indicated that overall survival (OS) was poorer in CY/TBI+AraC (hazard ratio [HR] 1.46, p < 0.001) and CY/TBI+VP16 (HR 1.39, p = 0.059) compared to CY/TBI. Relapse was not suppressed, while treatment-related mortality (TRM) was significantly higher (HR 1.78 and 1.74, p < 0.001 and 0.018, respectively). In the acute lymphoblastic leukemia (ALL) cohort (N = 3901, 61.2%), OS was comparable among these regimens. With intensified regimens, relapse was significantly suppressed in CY/TBI+VP16 (HR 0.74, p = 0.005), while TRM was higher (HR 1.21, p = 0.077). No interactions were observed regarding the country.
Conclusion
In AML adding AraC and VP16 to CY/TBI had an adverse effect on OS. Conversely, in ALL, adding VP16 or AraC to CY/TBI did not affect survival, but the addition of VP16 reduced the risk of relapse.
Clinical Trial Registration
The authors have confirmed clinical trial registration is not needed for this submission.
Citation
Y. Arai et al., “Efficacy of Total-Body Irradiation-based Intensified Myeloablative Regimens for Acute Leukemia—An International Collaborative Study,” EJHaem, vol. 6, no. 3, p. e70061, Jun. 2025, doi: 10.1002/JHA2.70061.
Source
EJHaem
Conference
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Subjects
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Publisher
Wiley