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    Annals of oncology : official journal of the European Society for Medical Oncology. 2011 Jan 18. pii: S0923-7534(19)38449-2. doi: 10.1093/annonc/mdq703
    No improvement of survival with reduced- versus high-intensity conditioning for allogeneic stem cell transplants in Ewing tumor patients.
    Thiel U1,  Wawer A2,  Wolf P3,  Badoglio M4,  Santucci A5,  Klingebiel T6,  Basu O7,  Borkhardt A8,  Laws HJ9,  Kodera Y10,  Yoshimi A11,  Peters C12,  Ladenstein R13,  Pession A14,  Prete A15,  Urban EC16,  Schwinger W17,  Bordigoni P18,  Salmon A19,  Diaz MA20,  Afanasyev B21,  Lisukov I22,  Morozova E23,  Toren A24,  Bielorai B25,  Korsakas J26,  Fagioli F27,  Caselli D28,  Ehninger G29,  Gruhn B30,  Dirksen U31,  Abdel-Rahman F32,  Aglietta M33,  Mastrodicasa E34,  Torrent M35,  Corradini P36,  Demeocq F37,  Dini G38,  Dreger P39,  Eyrich M40,  Gozdzik J41,  Guilhot F42,  Holler E43,  Koscielniak E44,  Messina C45,  Nachbaur D46,  Sabbatini R47,  Oldani E48,  Ottinger H49,  Ozsahin H50,  Schots R51,  Siena S52,  Stein J53,  Sufliarska S54,  Unal A55,  Ussowicz M56,  Schneider P57,  Woessmann W58,  Jürgens H59,  Bregni M60,  Burdach S61
    Author information
    1Department of Pediatrics and Wilhelm Sander Sarcoma Unit MRI, Pediatric Oncology Center, Technische Universität München.
    2Department of Pediatrics and Wilhelm Sander Sarcoma Unit MRI, Pediatric Oncology Center, Technische Universität München.
    3Institute for Medical Statistics and Epidemiology, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany.
    4EBMT Data & Study Office, Hopital Saint-Antoine, Assistance Publique des Hôpitaux de Paris and UPMC Univ Paris 06, Paris, France.
    5Section of Pediatric Hematology & Oncology, University of Perugia, Perugia, Italy.
    6Children's Hospital III, Department of Pediatrics, Johann Wolfgang Goethe University, Frankfurt.
    7Children's Hospital III, Department of Pediatrics, Johann Wolfgang Goethe University, Frankfurt.
    8Department of Pediatric Oncology, Hematology and Clinical Immunology, Heinrich Heine University, Düsseldorf, Germany.
    9Department of Pediatric Oncology, Hematology and Clinical Immunology, Heinrich Heine University, Düsseldorf, Germany.
    10Department of Promotion for Blood and Marrow Transplantation, Aichi Medical University, Aichi; APBMT Data Center, Nagoya University School of Medicine, Nagoya, Japan.
    11APBMT Data Center, Nagoya University School of Medicine, Nagoya, Japan.
    12Department of Pediatrics, St. Anna Kinderspital, Vienna, Austria.
    13Department of Pediatrics, St. Anna Kinderspital, Vienna, Austria.
    14Department of Scienze Pediatriche Mediche e Chirurgiche, Ospedale S Orsola Malpighi, Bologna, Italy.
    15Department of Scienze Pediatriche Mediche e Chirurgiche, Ospedale S Orsola Malpighi, Bologna, Italy.
    16Department of Pediatrics, Medical University of Graz, Graz, Austria.
    17Department of Pediatrics, Medical University of Graz, Graz, Austria.
    18Service de Transplantation Medullaire, CHU de Nancy Brabois, Vandoeuvre-les-Nancy, France.
    19Service de Transplantation Medullaire, CHU de Nancy Brabois, Vandoeuvre-les-Nancy, France.
    20Department of Pediatrics, Division of Pediatric Hematology-Oncology and Hematopoietic Stem Cell Transplantation and Cell Therapy Unit, Hospital Infantil Universitario Niño Jesus, Madrid, Spain.
    21St. Petersburg State Medical Pavlov University, Ratsa Gorbacheva Memorial Children`s Institute, Department of Hematology and Transplantology, St. Petersburg, Russia.
    22St. Petersburg State Medical Pavlov University, Ratsa Gorbacheva Memorial Children`s Institute, Department of Hematology and Transplantology, St. Petersburg, Russia.
    23St. Petersburg State Medical Pavlov University, Ratsa Gorbacheva Memorial Children`s Institute, Department of Hematology and Transplantology, St. Petersburg, Russia.
    24Pediatric Hemato-Oncology Unit, Sheba Medical Center (affiliated to the Sackler Faculty of Medicine), Tel Hashomer, Israel.
    25Pediatric Hemato-Oncology Unit, Sheba Medical Center (affiliated to the Sackler Faculty of Medicine), Tel Hashomer, Israel.
    26Department of Hematology, Oncology and Transfusion Medicine Center, Vilnius University Hospital Santariskiu Clinics, Vilnius, Lithuania.
    27Stem Cell Transplantation and Cellular Therapy Unit, Pediatric Onco-Hematology Division, "Regina Margherita" Children's Hospital, Turin.
    28Department of Oncoematologia Pediatrica, Azienda Ospedaliero-Universitaria Meyer, Florence, Italy.
    29Department of Internal Medicine I, University Hospital Carl Gustav Carus, Dresden.
    30Department of Pediatrics, University of Jena, Jena.
    31Department of Pediatric Hematology and Oncology, University Children's Hospital, Münster, Germany.
    32The Bone Marrow and Stem Cell Transplantation Program, King Hussein Cancer Center, Amman, Jordan.
    33Department of Istituto per la Ricerca e la Cura del Cancro, Turin, Italy.
    34Section of Pediatric Hematology & Oncology, University of Perugia, Perugia, Italy.
    35Hospital de la Santa Creu i Sant Pau, Department of Pediatrics, Barcelona, Spain.
    36Department of Hematology - Bone Marrow Transplantation Unit, Istituto Nazionale dei Tumori, University of Milano, Milan, Italy.
    37Centre Hospitalier et Universitaire de Clermont-Ferrand, Service de Pédiatrie B et Unité Bioclinique de Thérapie Cellulaire, Clermont-Ferrand, France.
    38Department of UO Ematologia ed Oncologia Pediatrica, Istituto G Gaslini, Genova, Italy.
    39Department of Internal Medicine V, University of Heidelberg, Heidelberg.
    40Children's Hospital, Department of Paediatric Stem Cell Transplantation, University of Würzburg, Würzburg, Germany.
    41Transplantation Centre, University Children's Hospital, Cracow, Poland.
    42Department of Hematology, University Hospital, Poitiers, France.
    43Department of Hematology and Oncology, University of Regensburg, Regensburg.
    44Department of Pediatrics 5 (Oncology, Hematology, Immunology), Olga Hospital, Klinikum Stuttgart, Stuttgart, Germany.
    45Hemo/Oncology, Department of Pediatrics, Hospital-University of Padova, Padova, Italy.
    46University Hospital of Innsbruck, Internal Medicine V, Department of Hematology and Oncology, Innsbruck, Austria.
    47Department of Oncology, Haematology, and Respiratory Diseases, Policlinico di Modena, Modena.
    48Department of U.S.C. Ematologia, Ospedali Riuniti, Bergamo, Italy.
    49Department of Bone Marrow Transplantation, University Hospital of Essen, Essen, Germany.
    50Paediatric Oncology Unit, University of Geneva Children's Hospital, Geneva, Switzerland.
    51Division of Clinical Hematology and BMT Unit, University Hospital Brussels, Brussels, Belgium.
    52Department of S. C. Divisione Oncologia Falck and S. C. Divisione Anatomia Patologica, Ospedale Niguarda Ca' Granda, Milan, Italy.
    53Bone marrow Transplant Unit, Department of Pediatric Hematology-Oncology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.
    54Bone Marrow Transplantation Unit, Department of Pediatrics, Comenius University Medical School, Bratislava, Slovak Republic.
    55Institutions Erciyes Medical School, Department of Hematology and Oncology, Kapadokya BMT Center, Kayseri, Turkey.
    56Department of Pediatric Hematology, Oncology and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland.
    57Department of Pediatric Hematology and Oncology, Hôpital Charles Nicolle, Rouen, France.
    58Department of Pediatric Hematology and Oncology, University Hospital, Giessen, Germany.
    59Department of Pediatric Hematology and Oncology, University Children's Hospital, Münster, Germany.
    60Unit of Medical Oncology, Ospedale San Giuseppe, Milan, Italy.
    61Department of Pediatrics and Wilhelm Sander Sarcoma Unit MRI, Pediatric Oncology Center, Technische Universität München. Electronic address: meta-eicess@lrz.tum.de.
    Abstract

    BACKGROUND: Outcomes of Ewing tumor (ET) patients treated with allogeneic stem cell transplantation (allo-SCT) were compared regarding the use of reduced-intensity conditioning (RIC) and high-intensity conditioning (HIC) regimens as well as human leukocyte antigen (HLA)-matched and HLA-mismatched grafts.

    PATIENTS AND METHODS: We retrospectively analyzed data of 87 ET patients from the European Group for Blood and Marrow Transplantation, Pediatric Registry for Stem Cell Transplantations, Asia Pacific Blood and Marrow Transplantation and MetaEICESS registries treated with allo-SCT. Fifty patients received RIC (group A) and 37 patients received HIC (group B). Twenty-four patients received HLA-mismatched grafts and 63 received HLA-matched grafts.

    RESULTS: Median overall survival was 7.9 months [±1.24, 95% confidence interval (CI) 5.44-10.31] for group A and 4.4 months (±1.06, 95% CI 2.29-6.43) for group B patients (P = 1.3). Death of complications (DOC) occurred in 4 of 50 (0.08) and death of disease (DOD) in 33 of 50 (0.66) group A and in 16 of 37 (0.43) and 17 of 37 (0.46) group B patients, respectively. DOC incidence was decreased (P < 0.01) and DOD/relapse increased (P < 0.01) in group A compared with group B. HLA mismatch was not generally associated with graft-versus-Ewing tumor effect (GvETE).

    CONCLUSIONS: There was no improvement of survival with RIC compared with HIC due to increased DOD/relapse incidence after RIC despite less DOC incidence. This implicates general absence of a clinically relevant GvETE with current protocols.


    Publikations ID: 21245159
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