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Allogeneic bone marrow transplantation for children with acute myeloblastic leukemia in first complete remission: impact of conditioning regimen without total-body irradiation--a report from the Société Française de Greffe de Moelle.
J Clin Oncol. 1994 Jun; 12(6):1217-22.JC

Abstract

PURPOSE

To analyze the French experience of chemotherapeutic preparation before human leukocyte antigen (HLA)-identical bone marrow transplantation (BMT) in children with acute myeloblastic leukemia (AML) in first complete remission (CR).

PATIENTS AND METHODS

The data base used for this study was a French BMT registry for childhood AML. Twenty-three children were conditioned with busulfan and 120 mg/kg cyclophosphamide (Bu-Cy 120 group). Nineteen received busulfan and 200 mg/kg cyclophosphamide (Bu-Cy200 group). During the same time period, 32 patients were prepared with total-body irradiation (TBI group) most often in combination with 120 mg/kg of cyclophosphamide.

RESULTS

The probability of relapse was 54%, 13%, and 10% for the Bu-Cy120, Bu-Cy200, and TBI groups, respectively (P < .05 in the univariate analysis, log-rank test, 2 df). In the multivariate analysis, a conditioning regimen with Bu-Cy120 was significantly associated with a higher risk of relapse (P = .02; relative risk, 3.62). The probability of transplant-related mortality (TRM) was 0% for Bu-Cy120, 5% for Bu-Cy200, and 10% for TBI. Kaplan-Meier estimations of event-free survival (EFS) were 46% +/- 24%, 82% +/- 18%, and 80% +/- 14%, respectively, for the three groups, with median follow-up durations of 28 months (range, 3 to 78), 31 months (4 to 68), and 48 months (2 to 73). In the multivariate analysis, two factors adversely affected EFS: a conditioning regimen with Bu-Cy120 (P = .07) and a long interval from diagnosis to BMT (> or = 120 days, P = .08).

CONCLUSION

Bu-Cy120 is a well-tolerated preparation, but results in a high risk of relapse for children with AML in first CR. This high risk of relapse is not observed when the dose of cyclophosphamide is increased to 200 mg/kg.

Authors+Show Affiliations

Service d'Hématologie Pédiatrique, Hôpital d'enfants La Timone, Marseille, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

8201385

Citation

Michel, G, et al. "Allogeneic Bone Marrow Transplantation for Children With Acute Myeloblastic Leukemia in First Complete Remission: Impact of Conditioning Regimen Without Total-body Irradiation--a Report From the Société Française De Greffe De Moelle." Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, vol. 12, no. 6, 1994, pp. 1217-22.
Michel G, Gluckman E, Esperou-Bourdeau H, et al. Allogeneic bone marrow transplantation for children with acute myeloblastic leukemia in first complete remission: impact of conditioning regimen without total-body irradiation--a report from the Société Française de Greffe de Moelle. J Clin Oncol. 1994;12(6):1217-22.
Michel, G., Gluckman, E., Esperou-Bourdeau, H., Reiffers, J., Pico, J. L., Bordigoni, P., Thuret, I., Blaise, D., Bernaudin, F., & Jouet, J. P. (1994). Allogeneic bone marrow transplantation for children with acute myeloblastic leukemia in first complete remission: impact of conditioning regimen without total-body irradiation--a report from the Société Française de Greffe de Moelle. Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, 12(6), 1217-22.
Michel G, et al. Allogeneic Bone Marrow Transplantation for Children With Acute Myeloblastic Leukemia in First Complete Remission: Impact of Conditioning Regimen Without Total-body Irradiation--a Report From the Société Française De Greffe De Moelle. J Clin Oncol. 1994;12(6):1217-22. PubMed PMID: 8201385.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Allogeneic bone marrow transplantation for children with acute myeloblastic leukemia in first complete remission: impact of conditioning regimen without total-body irradiation--a report from the Société Française de Greffe de Moelle. A1 - Michel,G, AU - Gluckman,E, AU - Esperou-Bourdeau,H, AU - Reiffers,J, AU - Pico,J L, AU - Bordigoni,P, AU - Thuret,I, AU - Blaise,D, AU - Bernaudin,F, AU - Jouet,J P, PY - 1994/6/1/pubmed PY - 1994/6/1/medline PY - 1994/6/1/entrez SP - 1217 EP - 22 JF - Journal of clinical oncology : official journal of the American Society of Clinical Oncology JO - J Clin Oncol VL - 12 IS - 6 N2 - PURPOSE: To analyze the French experience of chemotherapeutic preparation before human leukocyte antigen (HLA)-identical bone marrow transplantation (BMT) in children with acute myeloblastic leukemia (AML) in first complete remission (CR). PATIENTS AND METHODS: The data base used for this study was a French BMT registry for childhood AML. Twenty-three children were conditioned with busulfan and 120 mg/kg cyclophosphamide (Bu-Cy 120 group). Nineteen received busulfan and 200 mg/kg cyclophosphamide (Bu-Cy200 group). During the same time period, 32 patients were prepared with total-body irradiation (TBI group) most often in combination with 120 mg/kg of cyclophosphamide. RESULTS: The probability of relapse was 54%, 13%, and 10% for the Bu-Cy120, Bu-Cy200, and TBI groups, respectively (P < .05 in the univariate analysis, log-rank test, 2 df). In the multivariate analysis, a conditioning regimen with Bu-Cy120 was significantly associated with a higher risk of relapse (P = .02; relative risk, 3.62). The probability of transplant-related mortality (TRM) was 0% for Bu-Cy120, 5% for Bu-Cy200, and 10% for TBI. Kaplan-Meier estimations of event-free survival (EFS) were 46% +/- 24%, 82% +/- 18%, and 80% +/- 14%, respectively, for the three groups, with median follow-up durations of 28 months (range, 3 to 78), 31 months (4 to 68), and 48 months (2 to 73). In the multivariate analysis, two factors adversely affected EFS: a conditioning regimen with Bu-Cy120 (P = .07) and a long interval from diagnosis to BMT (> or = 120 days, P = .08). CONCLUSION: Bu-Cy120 is a well-tolerated preparation, but results in a high risk of relapse for children with AML in first CR. This high risk of relapse is not observed when the dose of cyclophosphamide is increased to 200 mg/kg. SN - 0732-183X UR - https://www.unboundmedicine.com/medline/citation/8201385/Allogeneic_bone_marrow_transplantation_for_children_with_acute_myeloblastic_leukemia_in_first_complete_remission:_impact_of_conditioning_regimen_without_total_body_irradiation__a_report_from_the_Société_Française_de_Greffe_de_Moelle_ DB - PRIME DP - Unbound Medicine ER -