TLI in pediatric patients
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A. Ocanto [1] ; A. Escribano [1] ; L. Glaría [1] ; I. Rodríguez [1] ; C. Ferrer [1] ; C. Huertas [1] ; A. Pérez [1] ; R. Morera [1]
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[1] Hospital Universitario La Paz
Hospital Universitario La Paz
Madrid, España
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- Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 22, Nº. 6, 2020, págs. 884-891
- Idioma: inglés
- Texto completo no disponible (Saber más ...)
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Resumen
Purpose Hematopoietic progenitor cell transplantation (HSCT) is a procedure used in different hematological diseases as part of the curative treatment, so the investigators propose a system of conditioning of reduced intensity based on total lymphoid irradiation (TLI) as an alternative to the classic total body irradiation (TBI) followed by haploidentical transplantation in patients compatible with a single HLA haplotype, as an alternative to patients who do not have an HLA compatible donor.
Materials and methods A cohort of 25 patients with hematological disease underwent haploidentical HSCT from February 2015 to May 2018, conditioned with TLI from day − 10 (2–4 days of treatment) followed by thiotepa (5 mg/kg/12 h) and melphalan (70 mg/m2/day) prior to HSCT and prophylaxis with ciclosporin (1.5 mg/kg/12 h). 2 Gy/fraction was administered to complete 8 Gy with IMRT and VMAT technique.
Results 12% rejection of the transplant was obtained with acute GVHD < II (48%) and chronic GVHD 12%. No acute toxicity was recorded in irradiated patients and 56% survival of patients at the end of follow-up.
Conclusion Conditioning the haploidentical transplant with TLI, IMRT, and VMAT techniques compared with TBI and RT3D-C techniques is a feasible technique that helps inducing the necessary immunosuppression in patients with a high risk of graft rejection, minimal adverse effects, low incidence of GVHD, and high survival rate.
