Outcomes of Total Body Irradiation-Based
Myeloablative Conditioning Regimen for Allogeneic
Stem Cell Transplantation in Pediatric Leukemia
Thiti Swangsilpa MD*, Puangtong Kraiphibul MD**,
Suradej Hongeng MD***, Samart Pakakasama MD***,
Mantana Dhanachai MD*, Somjai Dangprasert MD*, Chomporn Sitathanee MD*,
Putipun Puataweepong MD*, Chuleeporn Jiarpinitnun MD*, Usanarat Anurathapan MD***,
Duantida Songdej MD***, Patamintita Witoonpanich MD*, Orawan Rattanasuwan BSc, RN*
Affiliation :
* Radiation Oncology Division, Department of Radiology, Faculty of Medicine, Ramathibodi Hospital,
Mahidol University, Bangkok, Thailand
** Maha Vajiralongkorn Cancer Center, Pathumthani, Thailand
*** Hematology and Oncology Unit, Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital,
Mahidol University, Bangkok, Thailand
Background : The total body irradiation (TBI)-based myeloablative conditioning regimen for allogeneic stem cell transplantation
has been developed to overcome treatment failure and to improve overall survival of pediatric leukemia. The present study
retrospectively reports the safety and success of this treatment regimen.
Objective : The objective was to report the safety and success of this treatment program based on the evaluation of effectiveness
and complications from treatment, overall and disease free survival rate of patients and prognostic factors that might affect
survival outcome.
Material and Method: Forty-four pediatric leukemic patients received the TBI-based myeloablative conditioning regimen for
allogeneic stem cell transplantation at Ramathibodi Hospital between 1997 and 2011. The data were evaluated for clinical
outcome.
Results : With the median follow-up period at 5.9 years (ranging from 0.3 to 16.7 years), 29 cases (65.9%) were alive, 15
cases (34.1%) died. The Kaplan-Meier estimated that the overall survival rate was 72.5% after three years, 70% after five
years, and 63.0% after 10 years. The diseases free survival rates at 3, 5 and 10 years were 85.5%, 82.5%, and 82.5%,
respectively. Significantly, lower survival rate was observed in patients with relapsed disease prior to transplantation and in
patients with no remission of disease after transplantation.
Conclusion : The TBI-based myeloablative conditioning regimen for allogeneic stem cell transplantation can be applied to
management of selected pediatric leukemic patients.
Keywords : Total body irradiation, Myeloablative conditioning regimen, Allogeneic stem cell transplantation, Pediatric leukemia
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