J Clin Oncol:儿童ALL进行allo-HSCT前的最适清髓方案

2020-12-28 MedSci原创 MedSci原创

急性淋巴细胞白血病(ALL)小儿患者在异基因造血干细胞移植(HSCT)前采用全身放疗(TBI)的效果良好,但长期副作用令人担忧。FORUM研究评估了在这类患者中,预备性联合化疗是否可以替代TBI。

急性淋巴细胞白血病(ALL)小儿患者在异基因造血干细胞移植(HSCT)前采用全身放疗(TBI)的效果良好,但长期副作用令人担忧。FORUM研究评估了在这类患者中,预备性联合化疗是否可以替代TBI。

该研究是一项国际多中心、开放标签、随机对照的III期非劣效性试验,招募18岁及以下时确诊的、在4-21岁期间进行HSCT的、在HSCT前获得完全缓解的的患者,随机接受TBI(12 Gy)+依托泊苷 vs 氟达拉滨+硫替帕+白消安/硫丹清髓调理。非劣效性界值为8%。一旦达到非劣效性界值,则停止随机分配患者。

主要终点

2013年4月-2018年12月,共筛选了543位患者,其中417位参与随机分组,212位接受TBI,201位接受化疗调理。2019年3月31日达到非劣效性界值。中位随访2.1年。在意向治疗人群中,TBI后的2年总体存活率(OS)较化疗调理后的显著更高(0.91 vs 0.75)TBI组和化疗调理组的2年累计复发率分别为0.12 vs 0.33,治疗相关死亡率分别为0.02 vs 0.09

次要终点

该研究结果显示,TBI联合依托泊苷相比化疗调理的OS更好,复发风险更低。因此,对于4岁以上的拟进行异基因HSCT的高风险ALL患者还是宜采用TBI联合依托泊苷进行移植前的准备。

原始出处:

Christina Peters, et al. Total Body Irradiation or Chemotherapy Conditioning in Childhood ALL: A Multinational, Randomized, Noninferiority Phase III Study. Journal of Clinical Oncology. December 17, 2020.

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    2021-11-20 仁医06
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    2021-03-12 sjq035
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    2021-04-30 MedSciZeng

    #J Clin Oncol#点击查看更多该期刊内容

    0

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    2020-12-30 膀胱癌
  5. [GetPortalCommentsPageByObjectIdResponse(id=1865954, encodeId=402318659541c, content=<a href='/topic/show?id=16ce133504e' target=_blank style='color:#2F92EE;'>#Oncol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13350, encryptionId=16ce133504e, topicName=Oncol)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=55683, createdName=仁医06, createdTime=Sat Nov 20 01:31:04 CST 2021, time=2021-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1658618, encodeId=1b8c1658618b9, content=<a href='/topic/show?id=4d06914052' target=_blank style='color:#2F92EE;'>#HSC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9140, encryptionId=4d06914052, topicName=HSC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f4bd24890262, createdName=sjq035, createdTime=Fri Mar 12 05:31:04 CST 2021, time=2021-03-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=961846, encodeId=f97396184620, content=<a href='/topic/show?id=11cf104251a3' target=_blank style='color:#2F92EE;'>#J Clin Oncol#</a>点击查看更多该期刊内容, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=104251, encryptionId=11cf104251a3, topicName=J Clin Oncol)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20221103/2796e00c9b4549e3b313ed9e7accc68f/b52d6d98bbe04782b5a4e2dd1ee80be2.jpeg, createdBy=078e1614372, createdName=MedSciZeng, createdTime=Fri Apr 30 17:16:46 CST 2021, time=2021-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1329450, encodeId=83801329450ef, content=<a href='/topic/show?id=bb96232801' target=_blank style='color:#2F92EE;'>#ALL#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2328, encryptionId=bb96232801, topicName=ALL)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/1103841572/C2EFD5CFB07FE291138AD4FD0C98E3DE/100, createdBy=e3d52500031, createdName=膀胱癌, createdTime=Wed Dec 30 01:31:04 CST 2020, time=2020-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1578434, encodeId=61a415e843494, content=<a href='/topic/show?id=cabf914424' target=_blank style='color:#2F92EE;'>#HSCT#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9144, encryptionId=cabf914424, topicName=HSCT)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0df016405434, createdName=ms691033630344116, createdTime=Wed Dec 30 01:31:04 CST 2020, time=2020-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1038156, encodeId=3505103815666, content=谢谢梅斯分享这么多精彩信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=anti-cancer, createdTime=Mon Dec 28 13:31:04 CST 2020, time=2020-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=911581, encodeId=23259115812b, content=学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKibA62IFMeUJEmSyIe8DvYFeERuOsfrRd8iano7nENqQU1dRR3tqeQOUL3eqgYgEZRT2t2iaEsib0JEw/132, createdBy=66771693911, createdName=易水河, createdTime=Mon Dec 28 11:37:25 CST 2020, time=2020-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=911566, encodeId=ab2f9115666f, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20161015/IMG5801C4A734E137989.jpg, createdBy=51871947992, createdName=1070030296, createdTime=Mon Dec 28 10:38:16 CST 2020, time=2020-12-28, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1865954, encodeId=402318659541c, content=<a href='/topic/show?id=16ce133504e' target=_blank style='color:#2F92EE;'>#Oncol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13350, encryptionId=16ce133504e, topicName=Oncol)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=55683, createdName=仁医06, createdTime=Sat Nov 20 01:31:04 CST 2021, time=2021-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1658618, encodeId=1b8c1658618b9, content=<a href='/topic/show?id=4d06914052' target=_blank style='color:#2F92EE;'>#HSC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9140, encryptionId=4d06914052, topicName=HSC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f4bd24890262, createdName=sjq035, createdTime=Fri Mar 12 05:31:04 CST 2021, time=2021-03-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=961846, encodeId=f97396184620, content=<a href='/topic/show?id=11cf104251a3' target=_blank style='color:#2F92EE;'>#J Clin Oncol#</a>点击查看更多该期刊内容, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=104251, encryptionId=11cf104251a3, topicName=J Clin Oncol)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20221103/2796e00c9b4549e3b313ed9e7accc68f/b52d6d98bbe04782b5a4e2dd1ee80be2.jpeg, createdBy=078e1614372, createdName=MedSciZeng, createdTime=Fri Apr 30 17:16:46 CST 2021, time=2021-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1329450, encodeId=83801329450ef, content=<a href='/topic/show?id=bb96232801' target=_blank style='color:#2F92EE;'>#ALL#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2328, encryptionId=bb96232801, topicName=ALL)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/1103841572/C2EFD5CFB07FE291138AD4FD0C98E3DE/100, createdBy=e3d52500031, createdName=膀胱癌, createdTime=Wed Dec 30 01:31:04 CST 2020, time=2020-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1578434, encodeId=61a415e843494, content=<a href='/topic/show?id=cabf914424' target=_blank style='color:#2F92EE;'>#HSCT#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9144, encryptionId=cabf914424, topicName=HSCT)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0df016405434, createdName=ms691033630344116, createdTime=Wed Dec 30 01:31:04 CST 2020, time=2020-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1038156, encodeId=3505103815666, content=谢谢梅斯分享这么多精彩信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=anti-cancer, createdTime=Mon Dec 28 13:31:04 CST 2020, time=2020-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=911581, encodeId=23259115812b, content=学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKibA62IFMeUJEmSyIe8DvYFeERuOsfrRd8iano7nENqQU1dRR3tqeQOUL3eqgYgEZRT2t2iaEsib0JEw/132, createdBy=66771693911, createdName=易水河, createdTime=Mon Dec 28 11:37:25 CST 2020, time=2020-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=911566, encodeId=ab2f9115666f, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20161015/IMG5801C4A734E137989.jpg, createdBy=51871947992, createdName=1070030296, createdTime=Mon Dec 28 10:38:16 CST 2020, time=2020-12-28, status=1, ipAttribution=)]
    2020-12-28 anti-cancer

    谢谢梅斯分享这么多精彩信息

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1865954, encodeId=402318659541c, content=<a href='/topic/show?id=16ce133504e' target=_blank style='color:#2F92EE;'>#Oncol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13350, encryptionId=16ce133504e, topicName=Oncol)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=55683, createdName=仁医06, createdTime=Sat Nov 20 01:31:04 CST 2021, time=2021-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1658618, encodeId=1b8c1658618b9, content=<a href='/topic/show?id=4d06914052' target=_blank style='color:#2F92EE;'>#HSC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9140, encryptionId=4d06914052, topicName=HSC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f4bd24890262, createdName=sjq035, createdTime=Fri Mar 12 05:31:04 CST 2021, time=2021-03-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=961846, encodeId=f97396184620, content=<a href='/topic/show?id=11cf104251a3' target=_blank style='color:#2F92EE;'>#J Clin Oncol#</a>点击查看更多该期刊内容, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=104251, encryptionId=11cf104251a3, topicName=J Clin Oncol)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20221103/2796e00c9b4549e3b313ed9e7accc68f/b52d6d98bbe04782b5a4e2dd1ee80be2.jpeg, createdBy=078e1614372, createdName=MedSciZeng, createdTime=Fri Apr 30 17:16:46 CST 2021, time=2021-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1329450, encodeId=83801329450ef, content=<a href='/topic/show?id=bb96232801' target=_blank style='color:#2F92EE;'>#ALL#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2328, encryptionId=bb96232801, topicName=ALL)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/1103841572/C2EFD5CFB07FE291138AD4FD0C98E3DE/100, createdBy=e3d52500031, createdName=膀胱癌, createdTime=Wed Dec 30 01:31:04 CST 2020, time=2020-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1578434, encodeId=61a415e843494, content=<a href='/topic/show?id=cabf914424' target=_blank style='color:#2F92EE;'>#HSCT#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9144, encryptionId=cabf914424, topicName=HSCT)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0df016405434, createdName=ms691033630344116, createdTime=Wed Dec 30 01:31:04 CST 2020, time=2020-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1038156, encodeId=3505103815666, content=谢谢梅斯分享这么多精彩信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=anti-cancer, createdTime=Mon Dec 28 13:31:04 CST 2020, time=2020-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=911581, encodeId=23259115812b, content=学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKibA62IFMeUJEmSyIe8DvYFeERuOsfrRd8iano7nENqQU1dRR3tqeQOUL3eqgYgEZRT2t2iaEsib0JEw/132, createdBy=66771693911, createdName=易水河, createdTime=Mon Dec 28 11:37:25 CST 2020, time=2020-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=911566, encodeId=ab2f9115666f, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20161015/IMG5801C4A734E137989.jpg, createdBy=51871947992, createdName=1070030296, createdTime=Mon Dec 28 10:38:16 CST 2020, time=2020-12-28, status=1, ipAttribution=)]
    2020-12-28 易水河

    学习学习

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    2020-12-28 1070030296

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