Long-Term Outcomes of Patients with Acute Myelogenous Leukemia Treated with Myeloablative Fractionated Total Body Irradiation TBI-Based Conditioning with a Tacrolimus- and Sirolimus-Based Graft-versus-Host Disease Prophylaxis Regimen: 6-Year Follow-Up from a Single Center

摘要: ABSTRACT Cyclophosphamide (Cy)/etoposide combined with fractionated total body irradiation (FTBI) or i.v. busulfan (Bu) has been the main conditioning regimens for allogeneic hematopoietic cell transplantation (alloHCT) young patients acute myelogenous leukemia (AML) eligible a myeloablative (MAC) regimen. Recent data suggested that Bu could be preferred regimen in myeloid malignancies. However, Bu-based are associated higher rates of sinusoidal obstruction syndrome. Here we report long-term survival outcomes AML receiving FTBI Cy etoposide before undergoing alloHCT at City Hope (COH). We obtained retrospective review prospectively maintained institutional registry clinical 167 (median age, 41 years; range, 18 to 57 years) first second complete remission who underwent COH between 2005 and 2015. Eligible received MAC (1320 cGy) (120 mg/kg) unrelated donor (60 related transplantation. Graft-versus-host disease (GVHD) prophylaxis was provided tacrolimus sirolimus. In this study, 6-year overall 60% nonrelapse mortality 15%. The GRFS rate 45% 1 year 39% 2 years. also describe late metabolic effects cumulative incidence secondary malignancies (9.5%). Overall, adult patient population, our results compare favorably chemotherapy-based (i.v. Bu) without significant toxicity arising from TBI-based regimens.