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Allogeneic marrow transplantation in patients with acute myeloid leukemia in first remission: a randomized trial of two irradiation regimens.

Publication ,  Journal Article
Clift, RA; Buckner, CD; Appelbaum, FR; Bearman, SI; Petersen, FB; Fisher, LD; Anasetti, C; Beatty, P; Bensinger, WI; Doney, K
Published in: Blood
November 1, 1990

A randomized trial of 12.0 Gy versus 15.75 Gy of total body irradiation (TBI) was performed in patients with acute myeloid leukemia undergoing allogeneic marrow transplantation while in first complete remission. All patients received 120 mg/kg cyclophosphamide followed by TBI and marrow from HLA-identical siblings. Cyclosporine and methotrexate were used for prophylaxis against acute graft-versus-host disease (GVHD). Thirty-four patients received 2.0-Gy fractions of irradiation daily for 6 days and 37 received 2.25-Gy fractions daily for 7 days. The 3-year actuarial probabilities for relapse-free survival were 0.58 for the patients who received 12.0 Gy and 0.59 for those who received 15.75 Gy. The 3-year probabilities of relapse were 0.35 for the 12.0 Gy group and 0.12 for the 15.75 Gy group (P = .06). The 3-year probabilities of transplant-related mortality were 0.12 and 0.32, respectively (P = .04). The probability of moderate to severe acute GVHD was 0.21 for the 12.0 Gy group and 0.48 for the 15.75 Gy group (P = .02). Patients exposed to the higher irradiation dose received less immunoprophylaxis against, and had a higher incidence of, acute GVHD. The increased dose of TBI significantly reduced the probability of relapse but did not improve survival because of increased mortality from causes other than relapse.

Duke Scholars

Published In

Blood

ISSN

0006-4971

Publication Date

November 1, 1990

Volume

76

Issue

9

Start / End Page

1867 / 1871

Location

United States

Related Subject Headings

  • Whole-Body Irradiation
  • Transplantation, Autologous
  • Remission, Spontaneous
  • Prognosis
  • Prednisone
  • Middle Aged
  • Methotrexate
  • Male
  • Leukemia, Myeloid, Acute
  • Immunology
 

Citation

APA
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ICMJE
MLA
NLM
Clift, R. A., Buckner, C. D., Appelbaum, F. R., Bearman, S. I., Petersen, F. B., Fisher, L. D., … Doney, K. (1990). Allogeneic marrow transplantation in patients with acute myeloid leukemia in first remission: a randomized trial of two irradiation regimens. Blood, 76(9), 1867–1871.
Clift, R. A., C. D. Buckner, F. R. Appelbaum, S. I. Bearman, F. B. Petersen, L. D. Fisher, C. Anasetti, P. Beatty, W. I. Bensinger, and K. Doney. “Allogeneic marrow transplantation in patients with acute myeloid leukemia in first remission: a randomized trial of two irradiation regimens.Blood 76, no. 9 (November 1, 1990): 1867–71.
Clift RA, Buckner CD, Appelbaum FR, Bearman SI, Petersen FB, Fisher LD, et al. Allogeneic marrow transplantation in patients with acute myeloid leukemia in first remission: a randomized trial of two irradiation regimens. Blood. 1990 Nov 1;76(9):1867–71.
Clift RA, Buckner CD, Appelbaum FR, Bearman SI, Petersen FB, Fisher LD, Anasetti C, Beatty P, Bensinger WI, Doney K. Allogeneic marrow transplantation in patients with acute myeloid leukemia in first remission: a randomized trial of two irradiation regimens. Blood. 1990 Nov 1;76(9):1867–1871.

Published In

Blood

ISSN

0006-4971

Publication Date

November 1, 1990

Volume

76

Issue

9

Start / End Page

1867 / 1871

Location

United States

Related Subject Headings

  • Whole-Body Irradiation
  • Transplantation, Autologous
  • Remission, Spontaneous
  • Prognosis
  • Prednisone
  • Middle Aged
  • Methotrexate
  • Male
  • Leukemia, Myeloid, Acute
  • Immunology