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Blood, 13 August 2009, Vol. 114, No. 7, pp. 1429-1436. Prepublished online as a Blood First Edition Paper on June 15, 2009; DOI 10.1182/blood-2009-01-196303. This Article Full Text Full Text (PDF) Supplemental Appendix All Versions of this Article: blood-2009-01-196303v1 114/7/1429    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via CrossRef Google Scholar Articles by Pulsipher, M. A. Articles by Kadota, R. PubMed PubMed Citation Articles by Pulsipher, M. A. Articles by Kadota, R. Related Collections Transplantation Free Research Articles Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  TRANSPLANTATION Reduced-intensity allogeneic transplantation in pediatric patients ineligible for myeloablative therapy: results of the Pediatric Blood and Marrow Transplant Consortium Study ONC0313 Michael A. Pulsipher1, Kenneth M. Boucher2, Donna Wall3, Haydar Frangoul4, Michel Duval5, Rakesh K. Goyal6, Peter J. Shaw7, Ann E. Haight8, Michael Grimley9, Stephan A. Grupp10, Morris Kletzel11, and Richard Kadota12 1 Primary Children's Medical Center and 2 Department of Oncological Sciences, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City; 3 Paediatric Hematology/Oncology, CancerCare Manitoba, Winnepeg, MB; 4 Vanderbilt Children's Hospital, Nashville, TN; 5 Hopital Sainte-Justine, Université of Montreal, Montreal, QC; 6 Children's Hospital of Pittsburgh, PA; 7 Children's Hospital at Westmead, Westmead, Australia; 8 Children's Healthcare of Atlanta, Emory University School of Medicine, GA; 9 Methodist Children's Hospital of South Texas, San Antonio; 10 Children's Hospital of Philadelphia, PA; 11 Children's Memorial Medical Center at Chicago, IL; and 12 Rady Children's Hospital San Diego, CA The role of reduced-intensity conditioning (RIC) regimens in pediatric cancer treatment is unclear. To define the efficacy of a busulfan/fludarabine/antithymocyte globulin RIC regimen in pediatric patients ineligible for myeloablative transplantation, we completed a trial at 23 institutions in the Pediatric Blood and Marrow Transplant Consortium. Forty-seven patients with hematologic malignancies were enrolled. Sustained engraftment occurred in 98%, 89%, and 90%, and full donor chimerism was achieved in 88%, 76%, and 78% of evaluable related bone marrow/peripheral blood stem cells (BM/PBSCs), unrelated BM/PBSCs, and unrelated cord blood recipients. With a median follow-up of 24 months (range, 11-53 months), 2-year event-free survival, overall survival (OS), transplantation-related mortality, and relapse were 40%, 45%, 11%, and 43%, respectively. Univariate analysis revealed an inferior outcome when patients had undergone previous total body irradiation (TBI)–containing myeloablative transplantation (2-year OS, 23% vs 63% vs 52%, previous TBI transplantation vs no TBI transplantation vs no transplantation, P = .02) and when patients not previously treated with TBI had detectable disease at the time of the RIC procedure (2-year OS, 0% vs 63%, detectable vs nondetectable disease, P = .01). Favorable outcomes can be achieved with RIC approaches in pediatric patients in remission who are ineligible for myeloablative transplantation. This study was registered at www.clinicaltrials.gov as #NCT00795132 [ClinicalTrials.gov] . CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

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