Treatment of Acute Lymphoblastic Leukemia with Alternate Hemi-body Irradiation

Objective:To assess the role of alternative hemi-body irradiation (AHBI) in patients with acute lymphoblastic leukemia(ALL).Methods: Eleven patients with ALL received two-step AHBI on day 15 (13～19) following high-dose chemotherapy. Upper hemi-body irradiation (UHBI) and lower hemi-body irradiation (LHBI) were sequentially given as a single dose of 6～9 Gy at an interval of 25 (13～37) days. Fourteen recipients of autologous hematopoietic stem cell transplantation(AHSCT) during the same period were chosen as the controls.Results: Hematopoietic reconstitutions were observed in all AHBI recipients.The 3 year disease free survival(DFS) rate and the cumulative incidence of AHBI related mortality in patients having received AHBI were (47.73±17.55)%and 0,respectively.The median follow-up period was 803.5 (428～1 446) days. The 3 year DFS and the cumulative incidence of AHSCT related mortality in 14 ALL patients in the AHSCT group were(53.88±14.08)%and 14%,respectively. There was no significant difference in 3 year DFS between AHBI recipients and AHSCT recipients with ALL in this two groups(P0.05).Conclusion: AHBI provided a feasible approach for ALL.This strategy has several advantages which include desirable effectiveness, low costs, practical operation, and acceptable side effects.