Korean Journal of Pediatrics 2010;53(4):538-547.
Published online April 15, 2010.
Comparison of total body irradiation-based or non-total body irradiation-based conditioning regimens for allogeneic stem cell transplantation in pediatric leukemia patients
Sang Jeong Kim1, Dong Kyun Han1, Hee Jo Baek1, Dong Yeon Kim1, Taek Keun Nam2, Tai Ju Hwang1, Hoon Kook1
1Departments of Pediatrics, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju, Korea
2Departments of Radiation Oncology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju, Korea
소아 백혈병 환자의 동종 조혈모세포이식 전처치로서 전신방사선 조사 포함군과 비포함군의 비교
김상정1, 한동균1, 백희조1, 김동연1, 남택근2, 황태주1, 국훈1
1전남대학교 의과대학 소아과학교실
2화순전남대학교병원 방사선종양학과
Correspondence: 
Hoon Kook, Email: hoonkook@chonnam.ac.kr
Abstract
Purpose
: This study aims to compare the outcome of total body irradiation (TBI)- or non-TBI-containing conditioning regimens for leukemia in children.
Methods
: We retrospectively evaluated 77 children conditioned with TBI (n=40) or non-TBI (n=37) regimens, transplanted at Chonnam National University Hospital between January 1996 and December 2007. The type of transplantation, disease status at the time of transplant, conditioning regimen, engraftment kinetics, development of graft-versus-host disease (GVHD), complications, cause of deaths, overall survival (OS), and event-free survival (EFS) were compared between the 2 groups.
Results
: Among 34 patients with acute lymphoblastic leukemia (ALL), 28 (82.4%) were in the TBI group, while 72.7% (24/33) of patients with myeloid leukemia were in the non-TBI group. Although the 5-year EFS of the 2 groups was similar for all patients (62% vs 63%), the TBI group showed a better 5-year EFS than the non-TBI group when only ALL patients were analyzed (65% vs 17%; P =0.005). In acute myelogenous leukemia patients, the non-TBI group had better survival tendency (73% vs 38%; P=0.089). The incidence of GVHD, engraftment, survival, cause of death, and late complications was not different between the 2 groups.
Conclusion
: The TBI and non-TBI groups showed comparable results, but the TBI group showed a significantly higher 5-year EFS than the non-TBI group in ALL patients. Further prospective, randomized controlled studies involving larger number of patients are needed to assess the late-onset complications and to compare the socioeconomic quality of life.
Key Words: Transplantation conditioning, Leukemia, Hematopoietic stem cell, Child


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