Skip to content
DraconiticResearch
Search Sources API
190,869 studies31 sourcesUpdated 37 min ago
Peer-reviewedCC BY-NCClinical epidemiology

Real-World Outcomes of Total Body Irradiation versus Chemotherapy-Based Conditioning in Pediatric Acute Lymphoblastic Leukemia.

  • Wona Choi1,2,3
  • Jae Won Yoo4
  • Bo Yeon Choi1
  • Ki-Hoon Kim1,5
  • Yoona Choi6,7
  • Bo Kyung Kim8,9
  • Jung-Hyun Won10
  • Hyoung Jin Kang8,9
  • Howard Lee10,11,12,13
  • In Young Choi1
  • Nack-Gyun Chung4
13 affiliations
  1. 1Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
  2. 2School of Nursing, Hallym University, Chuncheon, Gangwon-do, 24252, Republic of Korea.
  3. 3Research Institute of Medical-Bio Convergence, Hallym University, Chuncheon, Gangwon-do, 24252, Republic of Korea.
  4. 4Division 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.
  5. 5Department of Biomedicine and Health Sciences, The Catholic University of Korea, Seoul, Republic of Korea.
  6. 6Child Cancer and Rare Disease Project, Seoul National University Hospital, Seoul, Republic of Korea.
  7. 7Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea.
  8. 8Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea.
  9. 9Seoul National University Cancer Research Institute, Seoul, Republic of Korea.
  10. 10Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Republic of Korea.
  11. 11Center for Convergence Approaches in Drug Development, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Republic of Korea.
  12. 12Department of Clinical Pharmacology and Therapeutics, Seoul National University Hospital, Seoul, Republic of Korea.
  13. 13Advanced Institutes of Convergence Technology, Suwon, Republic of Korea.
Read full textPDFDOICite

Abstract

Purpose

To compare outcomes after total body irradiation (TBI)-based and chemotherapy-based conditioning in pediatric acute lymphoblastic leukemia (ALL).Patients and methods

This 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

Of 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

Primary 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.

Related

  1. Impact of Obesity on Chemotherapy Pharmacokinetics, Toxicity, and Survival Outcomes in Pediatric Acute Lymphoblastic Leukemia.
    Arun Nair, Gillian Graifman, U Tahir +4
    CureusPeer-reviewedCC BYFull textEpidemiology & public healthEurope PMC
  2. Refining risk in historically high-risk pediatric B-cell acute lymphoblastic leukemia: response kinetics and outcomes
    Yasuo Kubota, Yasuhiro Okamoto, Toshihiko Imamura +7
    Blood NeoplasiaPeer-reviewedCC BY-NC-NDFull textEpidemiology & public healthDOAJEurope PMCEurope PMCPMC
  3. SMARCA4 MUTATIONS PROMOTE CHEMOTHERAPY RESISTANCE IN T-ACUTE LYMPHOBLASTIC LEUKEMIA THROUGH ALTERED CHROMATIN REMODELING AT AP1-ASSOCIATED REGULATORY REGIONS
    V. Garcia-Hernandez, M. Maqueda, G. Faccincani +10
    bioRxivPreprintAll rights reservedFull textOncologybioRxiv
  4. Addition of thiotepa to total body irradiation-based conditioning in allogeneic hematopoietic stem cell transplantation for relapsed/refractory acute leukemia and lymphoma: a propensity score-matched retrospective study.
    Minglu Li, Shuqin Zhang, Xiaoyong Man +4
    Annals of hematologyPeer-reviewedCC BY-NC-NDFull textGeneral medicineEurope PMCDOAJ
  5. Pediatric T-cell lymphoblastic lymphoma with t(9;17)(q34;q23)-associated N-terminally truncated NOTCH1 activation: a case report
    Ayako Yamamori, Daichi Sajiki, Yusuke Tsumura +9
    International Journal of HematologyPeer-reviewedCC BY 4.0Full textGeneral medicinePMC

Cite

BibTeXRIS
BibTeX
@article{choi2026realworld,
  title = {{Real-World Outcomes of Total Body Irradiation versus Chemotherapy-Based Conditioning in Pediatric Acute Lymphoblastic Leukemia.}},
  author = {Wona Choi and Jae Won Yoo and Bo Yeon Choi and Ki-Hoon Kim and Yoona Choi and Bo Kyung Kim and Jung-Hyun Won and Hyoung Jin Kang and Howard Lee and In Young Choi and Nack-Gyun Chung},
  journal = {Clinical epidemiology},
  year = {2026},
  month = oct,
  doi = {10.2147/clep.s593364},
  url = {https://europepmc.org/article/MED/42921521},
  note = {CC BY-NC},
}
RIS
TY  - JOUR
TI  - Real-World Outcomes of Total Body Irradiation versus Chemotherapy-Based Conditioning in Pediatric Acute Lymphoblastic Leukemia.
AU  - Wona Choi
AU  - Jae Won Yoo
AU  - Bo Yeon Choi
AU  - Ki-Hoon Kim
AU  - Yoona Choi
AU  - Bo Kyung Kim
AU  - Jung-Hyun Won
AU  - Hyoung Jin Kang
AU  - Howard Lee
AU  - In Young Choi
AU  - Nack-Gyun Chung
PY  - 2026
DA  - 2026/10/19
JO  - Clinical epidemiology
DO  - 10.2147/clep.s593364
UR  - https://europepmc.org/article/MED/42921521
AB  - Purpose  To compare outcomes after total body irradiation (TBI)-based and chemotherapy-based conditioning in pediatric acute lymphoblastic leukemia (ALL).Patients and methods  This 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  Of 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  Primary 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.
SN  - 1179-1349
ER  -