OncohematologyOncohematologyОнкогематология1818-83462413-4023Publishing House ABV Press7910.17650/1818-8346-2011-6-4-19-26HEMATOPOIETIC STEM CELL TRANSPLANTATIONТРАНСПЛАНТАЦИЯ ГЕМОПОЭТИЧЕСКИХ СТВОЛОВЫХ КЛЕТОКAllogeneic hematopoietic stem cells transplantation with reduced intensity conditioning regimen in children and adolescents with unfavorable forms of acute lymphoblastic leukemiaАллогенная трансплантация гемопоэтических клеток с режимами кондиционирования со сниженной интенсивностью доз у детей и подростков с прогностически неблагоприятными формами острого лимфобластного лейкозаSemenovaE. V.СеменоваЕ. В.
Russian Federation
alena-semenova@yandex.ruStanchevaN. V.СтанчеваН. В.
Russian Federation
AlyanskiyA. L.АлянскийА. Л.
Russian Federation
BabenkoE. V.БабенкоЕ. В.
Russian Federation
VavilovV. N.ВавиловВ. Н.
Russian Federation
MorozovaE. V.МорозоваЕ. В.
Russian Federation
BondarenkoS. N.БондаренкоС. Н.
Russian Federation
SipolA. A.СиполА. А.
Russian Federation
PainaO. V.ПаинаО. В.
Russian Federation
SlesarchukO. A.СлесарчукО. А.
Russian Federation
BarkhatovI. M.БархатовИ. М.
Russian Federation
ZubarovskayaL. S.ЗубаровскаяЛ. С.
Russian Federation
AfanasievB. V.АфанасьевБ. В.
Russian Federation
Memorial R.M. Gorbacheva Institute of Children Hematology and Transfusiology Saint-Petersburg Pavlov State Medical UniversityГБОУ Санкт-Петербургский государственный медицинский университет им. академика И.П. Павлова Минздравсоцразвития России Институт детской гематологии и трансплантологии им. Р.М. Горбачевой2311201164192623072014230720142011https://oncohematology.abvpress.ru/ongm/article/view/79

Treatment results of allogeneic hematopoietic stem cells transplantation (allo-HSCT) with myeloablative (MAC) and reduced intensity (RIC) conditioning regimen in children and adolescents with unfavorable forms of acute lymphoblastic leukemia (ALL) were shown. One hundred and two ALL patients aged 1 to 21 years (mean – 12 years) who received allo-HSCT from 2000 to 2010 (31 patients with RIC and 71 patients with MAC) are included in the study. Analysis of overall and event-free survival in both groups showed comparable efficacy. The use of RIC as alternative conditioning regimen in children and adolescents with high risk ALL and poor general condition, comorbidities and infectious complications are discussed.

В статье представлены результаты сравнения эффективности аллогенной трансплантации гемопоэтических клеток (аллоТГСК) с миелоаблативными (МАК) и режимами кондиционирования со сниженной интенсивностью доз (РИК) у детей и подростков с прогностически неблагоприятными формами острого лимфобластного лейкоза (ОЛЛ). В исследование включено 102 пациента в возрасте от 1 до 21 года (средний возраст – 12 лет) с ОЛЛ, получивших алло-ТГСК с 2000 по 2010 г. (31 больной с РИК и 71 пациент с МАК). Анализ общей и бессобытийной выживаемости в обеих группах показал сопоставимую эффективность. Авторы обсуждают возможность использования РИК как альтернативного варианта кондиционирования при аллоТГСК у детей и подростков с ОЛЛ группы высокого риска, имеющих плохое общее состояние, сопутствующую патологию и инфекционные осложнения.

allogeneic hematopoietic stem cells transplantationreduced intensity conditioning regimenchildren and adolescentsacute lymphoblastic leukemiaаллогенная трансплантация гемопоэтических стволовых клетокрежимы кондиционирования со сниженной интенсивностьюдети и подросткиострый лимфобластный лейкоз1. Eden T., Pui C.H., Schrappe M. et al. All children have a right to full access to treatment for cancer. Lancet 2004;364(9440):1121–2.Eden T., Pui C.H., Schrappe M. et al. All children have a right to full access to treatment for cancer. Lancet 2004;364(9440):1121–2.2. Pui C.H., Evans W.E. Treatment of acute lymphoblastic leukemia. N Engl J Med 2006;354(2):166–78.Pui C.H., Evans W.E. Treatment of acute lymphoblastic leukemia. N Engl J Med 2006;354(2):166–78.3. Chessells J.M., Veys P., Kempski H. et al. Long-term follow-up of relapsed childhood acute lymphoblastic leukaemia. Br J Haematol 2003;123:396–405.Chessells J.M., Veys P., Kempski H. et al. Long-term follow-up of relapsed childhood acute lymphoblastic leukaemia. Br J Haematol 2003;123:396–405.4. Nguyen K., Devidas M., Cheng S.C. et al. Factors influencing survival after relapse from acute lymphoblastic leukemia: A Children’s Oncology Group study. Leukemia 2008;22:2142–50.Nguyen K., Devidas M., Cheng S.C. et al. Factors influencing survival after relapse from acute lymphoblastic leukemia: A Children’s Oncology Group study. Leukemia 2008;22:2142–50.5. Афанасьев Б.В., Зубаровская Л.С. Трансплантация гемопоэтических стволовых клеток крови. Детская онкология. Руководство. СПб., 2002. С. 90–108.Афанасьев Б.В., Зубаровская Л.С. Трансплантация гемопоэтических стволовых клеток крови. Детская онкология. Руководство. СПб., 2002. С. 90–108.6. Румянцев А.Г., Масчан А.А. Трансплантация гемопоэтических стволовых клеток у детей. Руководство для врачей. М., 2003.Румянцев А.Г., Масчан А.А. Трансплантация гемопоэтических стволовых клеток у детей. Руководство для врачей. М., 2003.7. Kenney L.B., Nancarrow C.M., Najita J. et al. Health status of the oldest adult survivors of cancer during childhood. Cancer 2010;15:497–506.Kenney L.B., Nancarrow C.M., Najita J. et al. Health status of the oldest adult survivors of cancer during childhood. Cancer 2010;15:497–506.8. Sundberg K.K., Doukkali E., Lampic C. et al. Long-term survivors of childhood cancer report quality of life and health status in parity with a comparison group. Pediatr Blood Cancer 2010;55:337–43.Sundberg K.K., Doukkali E., Lampic C. et al. Long-term survivors of childhood cancer report quality of life and health status in parity with a comparison group. Pediatr Blood Cancer 2010;55:337–43.9. Abou-Mourad Y.R., Lau B.C., Barnett M.J. et al. Long-term outcome after allo-SCT: close follow-up on a large cohort treated with myeloablative regimens. Bone Marrow Transplantation 2010;45:295–302.Abou-Mourad Y.R., Lau B.C., Barnett M.J. et al. Long-term outcome after allo-SCT: close follow-up on a large cohort treated with myeloablative regimens. Bone Marrow Transplantation 2010;45:295–302.10. Slavin S., Nagler A. et al. Shifting towards better immunotherapy rather than more intensive chemoradiotherapy using a nonmyeloablative approach in patients with leukemia. In: Buchner T., Hiddemann W., Wormann B., Schellong G., Ritter J., Creutzig U. Acute leukemias. Prognostic factors and treatment strategies. Berlin: Springer, 1999; pp. 674–677.Slavin S., Nagler A. et al. Shifting towards better immunotherapy rather than more intensive chemoradiotherapy using a nonmyeloablative approach in patients with leukemia. In: Buchner T., Hiddemann W., Wormann B., Schellong G., Ritter J., Creutzig U. Acute leukemias. Prognostic factors and treatment strategies. Berlin: Springer, 1999; pp. 674–677.11. Giralt S., Estey E., Albitar M. et al. Engraftment of allogeneic hematopoetic progenitor cells with purine analog-containing chemotherapy: harnessing graft-versusleukemia without myeloablative therapy. Blood 1997;89(12):4531–6.Giralt S., Estey E., Albitar M. et al. Engraftment of allogeneic hematopoetic progenitor cells with purine analog-containing chemotherapy: harnessing graft-versusleukemia without myeloablative therapy. Blood 1997;89(12):4531–6.12. Champlin R. Nonmyeloablative chemotherapy with allogeneic hematopoietic transplantation as adoptive immunotherapy for malignancies. Hematology 1999:413–6.Champlin R. Nonmyeloablative chemotherapy with allogeneic hematopoietic transplantation as adoptive immunotherapy for malignancies. Hematology 1999:413–6.13. Storb R.F., Champlin R., Riddell S.R. et al. Non-myeloablative transplants for malignant disease. Hematology 2001:375–91.Storb R.F., Champlin R., Riddell S.R. et al. Non-myeloablative transplants for malignant disease. Hematology 2001:375–91.14. Kolb H.J., Schattenberg A. et al. Graftversusleukemia effect of donor lymphocyte transfusion in marrow grafted patients. Blood 1995;86:2041–4.Kolb H.J., Schattenberg A. et al. Graftversusleukemia effect of donor lymphocyte transfusion in marrow grafted patients. Blood 1995;86:2041–4.15. Weiden P.L., Sullivan K.M., Flournoy N. et al. Antileukemic effect of chronic graftversus- host disease: contribution to improved survival after allogeneic marrow transplantation. N Engl J Med 1981;304:1529–31.Weiden P.L., Sullivan K.M., Flournoy N. et al. Antileukemic effect of chronic graftversus- host disease: contribution to improved survival after allogeneic marrow transplantation. N Engl J Med 1981;304:1529–31.16. Sullivan K.M., Storb R., Buckner C.D. et al. Graft-versus-host-disease as adoptive immunotherapy in patients with advanced hematologic neoplasms. N Engl J Med 1989;320:828–33.Sullivan K.M., Storb R., Buckner C.D. et al. Graft-versus-host-disease as adoptive immunotherapy in patients with advanced hematologic neoplasms. N Engl J Med 1989;320:828–33.17. Mohty M., Labopin M., Tabrizzi R. et al. Reduced intensity conditioning allogeneic stem cell transplantation for adult patients with acute lymphoblastic leukemia: a retrospective study from the European Group for Blood and Marrow Transplantation Haematologica 2008;93(2):303–6.Mohty M., Labopin M., Tabrizzi R. et al. Reduced intensity conditioning allogeneic stem cell transplantation for adult patients with acute lymphoblastic leukemia: a retrospective study from the European Group for Blood and Marrow Transplantation Haematologica 2008;93(2):303–6.18. Bachanova V., Verneris M.R., DeFor T. et al. Prolonged survival in adults with acute lymphoblastic leukemia after reducedintensity conditioning with cord blood or sibling donor transplantation. Blood 2009;26;113 (13):2902–5.Bachanova V., Verneris M.R., DeFor T. et al. Prolonged survival in adults with acute lymphoblastic leukemia after reducedintensity conditioning with cord blood or sibling donor transplantation. Blood 2009;26;113 (13):2902–5.19. Pulsipher M.A., Boucher K.M., all D. et al. Redused-intensity allogeneic transplantation in pediatric patients ineligible for myeloablative therapy: results of the Pediatric Blood and Marrow Transplant Consortium Study ONC0313. Blood 2009;114:1429–36.Pulsipher M.A., Boucher K.M., all D. et al. Redused-intensity allogeneic transplantation in pediatric patients ineligible for myeloablative therapy: results of the Pediatric Blood and Marrow Transplant Consortium Study ONC0313. Blood 2009;114:1429–36.20. Verneris M.R., Eapen M., Duerst R. et al. Redused-Intensity conditioning regimens for allogeneic transplantation in children with acute lymphoblastic leukemia. Biol BloodMarrow Transplant 2010:1–8.Verneris M.R., Eapen M., Duerst R. et al. Redused-Intensity conditioning regimens for allogeneic transplantation in children with acute lymphoblastic leukemia. Biol BloodMarrow Transplant 2010:1–8.21. Horowitz M., Gale R.P., Sondel P.M.,Goldman J.M. et al. Graft-versus-leukemia reactions after bone marrow transplantation. Blood 1990;75;555–62.Horowitz M., Gale R.P., Sondel P.M.,Goldman J.M. et al. Graft-versus-leukemia reactions after bone marrow transplantation. Blood 1990;75;555–62.22. Stackelberg A., Volzke E., Kuhl J.-S. et al. Outcome of children and adolescents with relapsed acute lymphoblastic leukaemia and non-response to salvage protocol therapy: a retrospective analysis of the ALL-REZ BFM Study Group. Eur J Cancer 2011;47(1):90–7.Stackelberg A., Volzke E., Kuhl J.-S. et al. Outcome of children and adolescents with relapsed acute lymphoblastic leukaemia and non-response to salvage protocol therapy: a retrospective analysis of the ALL-REZ BFM Study Group. Eur J Cancer 2011;47(1):90–7.23. Michallet M., Bilger K., Garban F. et al. Allogeneic hematopoietic stem-cell transplantation after nonmyeloablative preparative regimens: impact ofpretrans plantation and posttransplantation factors on outcome. J Clin Oncol 2001;19(14):3340–9.Michallet M., Bilger K., Garban F. et al. Allogeneic hematopoietic stem-cell transplantation after nonmyeloablative preparative regimens: impact ofpretrans plantation and posttransplantation factors on outcome. J Clin Oncol 2001;19(14):3340–9.