Trial reportJournal of clinical oncology : official journal of the American Society of Clinical Oncology2021
Total Body Irradiation or Chemotherapy Conditioning in Childhood ALL: A Multinational, Randomized, Noninferiority Phase III Study.
Trial report in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 183 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Allogeneic Stem Cell Transplantation for Children and Adolescents With Acute Lymphoblastic Leukaemia
Framework for Optimizing, Refining, and Unifying Management of HSCT in Pediatric ALL
Chlorophyllin as an Adjunct for Reducing Oral Mucositis in Myeloablative Total Body Irradiation
Who cites it
183 citing papers in PubMed, 5 syntheses or guidelines pooled it, 317 citations in OpenAlex.
- HLA matching in contemporary haematopoietic cell transplantation: Recommendations from the EBMT Practice Harmonisation and Guidelines Committee.Bone marrow transplantation · 2026Guideline
- American Society of Hematology 2026 guidelines for management of relapsed/refractory acute lymphoblastic leukemia in adolescents and young adults.Blood advances · 2026Guideline
- The complications of irradiation or busulfan for CAYA before hematopoietic stem cell transplantation: a systematic review and meta-analysis.Frontiers in pediatrics · 2026Pooled it
- Indications for haematopoietic cell transplantation and CAR-T for haematological diseases, solid tumours and immune disorders: 2025 EBMT practice recommendations.Bone marrow transplantation · 2025Guideline
- Thyroid function disorders and secondary cancer following haematopoietic stem cell transplantation in pediatrics: State of the art and practical recommendations for a risk-based follow-up.Frontiers in endocrinology · 2022Pooled it
- Refining busulfan exposure enhances pediatric ALL HSCT outcomes: insights from the International FORUM study.Blood advances · 2026Trial
- Impact of minimal residual disease on the outcome of hematopoietic stem cell transplantation for childhood acute lymphoblastic leukemia within the FORUM trial.Haematologica · 2026Trial
- Comparable outcomes after busulfan- or treosulfan-based conditioning for allo-HSCT in children with ALL: results of FORUM.Blood advances · 2025Trial
- Memory T-cell enriched haploidentical transplantation with NK cell addback results in promising long-term outcomes: a phase II trial.Journal of hematology & oncology · 2024Trial
- Low rate of nonrelapse mortality in under-4-year-olds with ALL given chemotherapeutic conditioning for HSCT: a phase 3 FORUM study.Blood advances · 2024Trial
- Treosulfan vs busulfan conditioning for allogeneic bmt in children with nonmalignant disease: a randomized phase 2 trial.Bone marrow transplantation · 2024Trial
- Feasibility study of total marrow lymphoid irradiation with volumetric modulated arc therapy: clinical implementation in a tertiary care center.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2023Trial
- Busulfan Plus Cyclophosphamide Versus Total Body Irradiation Plus Cyclophosphamide for Adults Acute B Lymphoblastic Leukemia: An Open-Label, Multicenter, Phase III Trial.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2023Trial
- Myeloablative conditioning with thiotepa-busulfan-fludarabine does not improve the outcome of patients transplanted with active leukemia: final results of the GITMO prospective trial GANDALF-01.Bone marrow transplantation · 2022Trial
- Expanding the conditioning armamentarium in adult acute lymphoblastic leukaemia: is treosulfan ready to challenge total body irradiation?Bone marrow transplantation · 2026Article
- Idiopathic Pneumonia Syndrome and Pulmonary Toxicity After Total Body Irradiation for Bone Marrow Transplantation in the Modern Transplant Era.Current oncology (Toronto, Ont.) · 2026Article
- Fludarabine combined with treosulfan or total body irradiation as a conditioning therapy before allogeneic hematopoietic stem cell transplantation in acute lymphoblastic leukemia. A retrospective matched-pair analysis from the ALWP of the EBMT.Bone marrow transplantation · 2026Article
- Hematopoietic cell transplantation after CD19-directed CAR T-cell therapy for remission consolidation or relapse treatment in pediatric acute lymphoblastic leukemia.Haematologica · 2026Article
- Impact of Graft Source on Outcomes of Pediatric B Cell Acute Lymphoblastic Leukemia: A Secondary CIBMTR Analysis With Pretransplant Measurable Residual Disease Data.Transplantation and cellular therapy · 2026Article
- Pregnancy outcomes in women conceiving after hematopoietic stem cell transplantation versus conventional chemotherapy for childhood or adolescent acute leukemia.Bone marrow transplantation · 2026Article
123 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
35 authors at 20 institutions in 19 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTotal body irradiation (TBI) before allogeneic hematopoietic stem cell transplantation (HSCT) in pediatric patients with acute lymphoblastic leukemia (ALL) is efficacious, but long-term side effects are concerning. We investigated whether preparative combination chemotherapy could replace TBI in such patients. PATIENTS AND
methodsFORUM is a randomized, controlled, open-label, international, multicenter, phase III, noninferiority study. Patients ≤ 18 years at diagnosis, 4-21 years at HSCT, in complete remission pre-HSCT, and with an HLA-compatible related or unrelated donor were randomly assigned to myeloablative conditioning with fractionated 12 Gy TBI and etoposide versus fludarabine, thiotepa, and either busulfan or treosulfan. The noninferiority margin was 8%. With 1,000 patients randomly assigned in 5 years, 2-year minimum follow-up, and one-sided alpha of 5%, 80% power was calculated. A futility stopping rule would halt random assignment if chemoconditioning was significantly inferior to TBI (EudraCT: 2012-003032-22; ClinicalTrials.gov: NCT01949129).
resultsBetween April 2013 and December 2018, 543 patients were screened, 417 were randomly assigned, 212 received TBI, and 201 received chemoconditioning. The stopping rule was applied on March 31, 2019. The median follow-up was 2.1 years. In the intention-to-treat population, 2-year overall survival (OS) was significantly higher following TBI (0.91; 95% CI, 0.86 to 0.95;
conclusionImproved OS and lower relapse risk were observed following TBI plus etoposide compared with chemoconditioning. We therefore recommend TBI plus etoposide for patients > 4 years old with high-risk ALL undergoing allogeneic HSCT.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.