Abstract

Total body irradiation (TBI)/ cyclophosphamide (CY) is a standard- of- care exertion authority in allogeneic hematopoietic stem cell transplant (HSCT) for pediatric acute lymphoblastic leukemia (ALL). This study sought to identify whether the addition of thiotepa (TT) to TBI/ CY improves HSCT issues for pediatric cases with ALL. A retrospective analysis was performed on 347 pediatric ALL cases who passed HSCT between 1995 and 2015, with 242 entering TBI/ CY/ TT and 105 cases entering TBI/ CY. There were no statistical differences in age, patron source, or complete absolution status between the 2 groups. Comparison of the TBI/ CY/ TT versus TBI/ CY groups demonstrated no difference in transplant- related mortality at 1(11 versus 11), 5(13 versus 16), or 10 times (16 versus 16). There was lower relapse in the TBI/ CY/ TT group at 1( 14 versus 26), 5( 24 versus 36), 10( 26 versus 37), and 15 times( 26 versus 37)( P = .02) but wasn't statistically significant on multivariate analysis. The TBI/ CY/ TT group showed a trend toward bettered complaint-free survival( DFS) at 5( 59 versus 47), 10( 56 versus 46), and 15 times( 49 versus 40)( P = .05) but wasn't statistically significant on multivariate analysis. Comparing overall survival at 5(62 versus 53), 10(57 versus 50), and 15 times (50 versus 44) demonstrated no statistical difference between the 2 groups. The addition of thiotepa to TBI/ CY demonstrated no increase in transplant- related mortality for pediatric ALL HSCT but was unfit to demonstrate significant benefit in complaint control. Minimum residual complaint status remained the crucial threat factor impacting both fall and DFS. Further studies are warranted to more clarify the benefits of using thiotepa in exertion for ALL HSCT.