{
  "abstract": "Purpose\n\nTo compare outcomes after total body irradiation (TBI)-based and chemotherapy-based conditioning in pediatric acute lymphoblastic leukemia (ALL).Patients and methods\n\nThis retrospective two-center PeARL registry cohort comprised 325 patients diagnosed with ALL at age ≤18 years who underwent first allogeneic hematopoietic stem cell transplantation during 2009-2023. Primary Cox and Fine-Gray models used full follow-up, adjusted for transplantation age, remission status and donor type, and were stratified by center. Propensity-score weighting was supplementary. Graft-versus-host disease (GVHD) analyses excluded recorded cases with unavailable or inconsistent onset dates and accounted for competing relapse and death; acute GVHD included any or unspecified grade.Results\n\nOf 325 patients, 210 received TBI-based and 115 chemotherapy-based conditioning; median follow-up by reverse Kaplan-Meier was 5.85 and 1.88 years, respectively. Unweighted 5-year overall survival was 65.5% versus 67.1%, and leukemia-free survival was 57.5% versus 53.4%. Adjusted hazard ratios were 1.30 (95% confidence interval [CI], 0.54-3.12) and 0.92 (0.43-2.01), respectively. Adjusted subdistribution hazard ratios were 0.79 (0.31-2.07) for relapse and 1.39 (0.43-4.49) for non-relapse mortality (NRM); supplementary propensity-score-weighted NRM estimates ranged from 4.20 to 6.48. Among patients included in the respective GVHD time-to-event analyses, 100-day acute GVHD cumulative incidence was 62.7% versus 32.2% (n=315), and 5-year chronic GVHD cumulative incidence was 24.9% versus 5.2% (n=314).Conclusion\n\nPrimary analyses did not detect statistically significant survival differences, but clinically important differences could not be excluded. NRM estimates varied across analyses. Non-random treatment selection, unequal follow-up, incomplete outcome recording and residual confounding limit causal interpretation.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.",
    "School of Nursing, Hallym University, Chuncheon, Gangwon-do, 24252, Republic of Korea.",
    "Research Institute of Medical-Bio Convergence, Hallym University, Chuncheon, Gangwon-do, 24252, Republic of Korea.",
    "Division of Pediatric Hematology and Oncology, Department of Pediatrics, Catholic Hematology Hospital, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.",
    "Department of Biomedicine and Health Sciences, The Catholic University of Korea, Seoul, Republic of Korea.",
    "Child Cancer and Rare Disease Project, Seoul National University Hospital, Seoul, Republic of Korea.",
    "Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea.",
    "Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea.",
    "Seoul National University Cancer Research Institute, Seoul, Republic of Korea.",
    "Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Republic of Korea.",
    "Center for Convergence Approaches in Drug Development, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Republic of Korea.",
    "Department of Clinical Pharmacology and Therapeutics, Seoul National University Hospital, Seoul, Republic of Korea.",
    "Advanced Institutes of Convergence Technology, Suwon, Republic of Korea."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 11,
  "authors": [
    {
      "affs": [
        0,
        1,
        2
      ],
      "name": "Wona Choi"
    },
    {
      "affs": [
        3
      ],
      "name": "Jae Won Yoo"
    },
    {
      "affs": [
        0
      ],
      "name": "Bo Yeon Choi",
      "orcid": "0000-0003-1311-2645"
    },
    {
      "affs": [
        0,
        4
      ],
      "name": "Ki-Hoon Kim"
    },
    {
      "affs": [
        5,
        6
      ],
      "name": "Yoona Choi",
      "orcid": "0000-0001-8948-1880"
    },
    {
      "affs": [
        7,
        8
      ],
      "name": "Bo Kyung Kim"
    },
    {
      "affs": [
        9
      ],
      "name": "Jung-Hyun Won"
    },
    {
      "affs": [
        7,
        8
      ],
      "name": "Hyoung Jin Kang"
    },
    {
      "affs": [
        9,
        10,
        11,
        12
      ],
      "name": "Howard Lee",
      "orcid": "0000-0001-6713-5418"
    },
    {
      "affs": [
        0
      ],
      "name": "In Young Choi",
      "orcid": "0000-0002-2860-9411"
    },
    {
      "affs": [
        3
      ],
      "name": "Nack-Gyun Chung"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/d30yfjb1qntcv.bib",
  "cited_by": 0,
  "doi": "10.2147/clep.s593364",
  "fulltext_url": "https://europepmc.org/articles/PMC13693522",
  "id": "d30yfjb1qntcv",
  "issns": [
    "1179-1349"
  ],
  "landing_url": "https://europepmc.org/article/MED/42921521",
  "language": "eng",
  "licence": "CC-BY-NC",
  "licence_label": "CC BY-NC",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2720|Hematopoietic Stem Cell Transplantation"
    ]
  ],
  "openalex": "W7222927255",
  "pdf_url": "https://europepmc.org/articles/PMC13693522?pdf=render",
  "pmcid": "PMC13693522",
  "pmid": "42921521",
  "published": "2026-10-19",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/d30yfjb1qntcv.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:33Z",
      "native_id": "MED:42921521",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42921521"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2720|Hematopoietic Stem Cell Transplantation",
      "subfield": "general"
    }
  ],
  "title": "Real-World Outcomes of Total Body Irradiation versus Chemotherapy-Based Conditioning in Pediatric Acute Lymphoblastic Leukemia.",
  "title_text": "Real-World Outcomes of Total Body Irradiation versus Chemotherapy-Based Conditioning in Pediatric Acute Lymphoblastic Leukemia.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:33Z",
  "url": "https://research.draconitic.com/paper/d30yfjb1qntcv",
  "venue": "Clinical epidemiology",
  "versions": []
}