Hematopoietic Stem Cell Transplantation Based on Minimal Residual Disease with a Unified Conditioning Regimen Comprising Total Body Irradiation, Etoposide and Cyclophosphamide: Results from the JPLSG ALL-R08-II Trial, the First Nationwide Prospective Study for Children with Intermediate-Risk Relapsed Acute Lymphoblastic Leukemia in Japan
Bibliographic record
Abstract
Background: In children with intermediate-risk relapsed acute lymphoblastic leukemia (ALL), allogeneic hematopoietic stem cell transplantation (allo-HSCT) has markedly improved the outcome of patients with poor minimal residual disease (MRD) response. However, there is no consensus on the optimal conditioning regimen for allo-HSCT. Procedure: We prospectively analyzed the efficacy and safety of allo-HSCT with a unified conditioning regimen for children with intermediate-risk relapsed ALL, based on MRD in the bone marrow after induction, in the Japanese Pediatric Leukemia/Lymphoma Study Group (JPLSG) ALL-R08-II nationwide cohort. The conditioning regimen for allo-HSCT comprised total body irradiation (TBI), etoposide (ETP) and cyclophosphamide (CY) (UMIN000002025). Results: Twenty patients with post-induction MRD ≥ 10 −3 and two with MRD that could not be evaluated underwent allo-HSCT. Engraftment was confirmed in all patients. No transplantation-related mortality was observed. The 3-year event-free survival and overall survival after transplantation were 86.4% ± 7.3% and 95.5% ± 4.4%, respectively. Conclusion: Allo-HSCT based on post-induction MRD with TBI + ETP + CY conditioning was highly effective and feasible for Japanese children with intermediate-risk relapsed ALL.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".