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Busulfan plus cyclophosphamide compared with total-body irradiation plus cyclophosphamide before marrow transplantation for myeloid leukemia: long-term follow-up of 4 randomized studies.

Publication ,  Journal Article
Socié, G; Clift, RA; Blaise, D; Devergie, A; Ringden, O; Martin, PJ; Remberger, M; Deeg, HJ; Ruutu, T; Michallet, M; Sullivan, KM; Chevret, S
Published in: Blood
December 15, 2001

In the early 1990s, 4 randomized studies compared conditioning regimens before transplantation for leukemia with either cyclophosphamide (CY) and total-body irradiation (TBI), or busulfan (Bu) and CY. This study analyzed the long-term outcomes for 316 patients with chronic myeloid leukemia (CML) and 172 patients with acute myeloid leukemia (AML) who participated in these 4 trials, now with a mean follow-up of more than 7 years. Among patients with CML, no statistically significant difference in survival or disease-free survival emerged from testing the 2 regimens. The projected 10-year survival estimates were 65% and 63% with Bu-CY versus CY-TBI, respectively. Among patients with AML, the projected 10-year survival estimates were 51% and 63% (95% CI, 52%-74%) with Bu-CY versus CY-TBI, respectively. At last follow-up, most surviving patients had unimpaired health and had returned to work, regardless of the conditioning regimen. Late complications were analyzed after adjustment for patient age and for acute and chronic graft-versus-host disease (GVHD). CML patients who received CY-TBI had an increased risk of cataract formation, and patients treated with Bu-CY had an increased risk of irreversible alopecia. Chronic GVHD was the primary risk factor for late pulmonary disease and avascular osteonecrosis. Thus, Bu-CY and CY-TBI provided similar probabilities of cure for patients with CML. In patients with AML, a nonsignificant 10% lower survival rate was observed after Bu-CY. Late complications occurred equally after both conditioning regimens (except for increased risk of cataract after CY-TBI and of alopecia with Bu-CY).

Duke Scholars

Published In

Blood

DOI

ISSN

0006-4971

Publication Date

December 15, 2001

Volume

98

Issue

13

Start / End Page

3569 / 3574

Location

United States

Related Subject Headings

  • Whole-Body Irradiation
  • Transplantation Conditioning
  • Retrospective Studies
  • Osteonecrosis
  • Neoplasm Metastasis
  • Lung Diseases
  • Leukemia, Myeloid, Acute
  • Leukemia, Myeloid
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive
  • Immunosuppressive Agents
 

Citation

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Socié, G., Clift, R. A., Blaise, D., Devergie, A., Ringden, O., Martin, P. J., … Chevret, S. (2001). Busulfan plus cyclophosphamide compared with total-body irradiation plus cyclophosphamide before marrow transplantation for myeloid leukemia: long-term follow-up of 4 randomized studies. Blood, 98(13), 3569–3574. https://doi.org/10.1182/blood.v98.13.3569
Socié, G., R. A. Clift, D. Blaise, A. Devergie, O. Ringden, P. J. Martin, M. Remberger, et al. “Busulfan plus cyclophosphamide compared with total-body irradiation plus cyclophosphamide before marrow transplantation for myeloid leukemia: long-term follow-up of 4 randomized studies.Blood 98, no. 13 (December 15, 2001): 3569–74. https://doi.org/10.1182/blood.v98.13.3569.
Socié G, Clift RA, Blaise D, Devergie A, Ringden O, Martin PJ, Remberger M, Deeg HJ, Ruutu T, Michallet M, Sullivan KM, Chevret S. Busulfan plus cyclophosphamide compared with total-body irradiation plus cyclophosphamide before marrow transplantation for myeloid leukemia: long-term follow-up of 4 randomized studies. Blood. 2001 Dec 15;98(13):3569–3574.

Published In

Blood

DOI

ISSN

0006-4971

Publication Date

December 15, 2001

Volume

98

Issue

13

Start / End Page

3569 / 3574

Location

United States

Related Subject Headings

  • Whole-Body Irradiation
  • Transplantation Conditioning
  • Retrospective Studies
  • Osteonecrosis
  • Neoplasm Metastasis
  • Lung Diseases
  • Leukemia, Myeloid, Acute
  • Leukemia, Myeloid
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive
  • Immunosuppressive Agents