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Allogeneic bone marrow transplantation vs aggressive post-remission chemotherapy for children with acute myeloid leukemia in first complete remission. A prospective study from the French Society of Pediatric Hematology and Immunology (SHIP).
Bone Marrow Transplant. 1996 Feb; 17(2):191-6.BM

Abstract

The objective of this study was to compare allogeneic bone marrow transplantation (BMT) with high-dose cytarabine containing chemotherapy in children with acute myeloid leukemia (AML) in first complete remission (CR). One hundred and seventy-one children were enrolled on the LAME89/91 protocol. Induction chemotherapy was a combination of cytarabine and mitoxantrone. After achieving CR, patients who had an HLA-identical sibling donor underwent allogeneic BMT. Children not eligible for BMT received post remission chemotherapy which included two consolidation courses, the second consolidation consisting of high-dose cytarabine with amsacrine and asparaginase. CR was achieved in 149 children (87%). Thirty-two had an HLA-identical sibling donor and were eligible for BMT. These 32 patients, as well as an additional child who had a one antigen HLA-mismatched father, received BMT during first CR. Consequently, 33 patients were analyzed in the BMT group and 116 in the chemotherapy group. The 4-year probability of relapse was 26 +/- 15% in the BMT group and 47 +/- 10% in the chemotherapy group (P = 0.04). The risk of therapy-related death was 3% for BMT and 7.7% for chemotherapy. Disease-free survival (DFS) was 72 +/- 15% in the BMT group and 48 +/- 10% in the chemotherapy group (p = 0.02). We conclude that allogeneic BMT from a matched sibling donor is the treatment of choice for reducing the relapse risk and for increasing DFS in children with AML in first CR.

Authors+Show Affiliations

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 availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

8640165

Citation

Michel, G, et al. "Allogeneic Bone Marrow Transplantation Vs Aggressive Post-remission Chemotherapy for Children With Acute Myeloid Leukemia in First Complete Remission. a Prospective Study From the French Society of Pediatric Hematology and Immunology (SHIP)." Bone Marrow Transplantation, vol. 17, no. 2, 1996, pp. 191-6.
Michel G, Leverger G, Leblanc T, et al. Allogeneic bone marrow transplantation vs aggressive post-remission chemotherapy for children with acute myeloid leukemia in first complete remission. A prospective study from the French Society of Pediatric Hematology and Immunology (SHIP). Bone Marrow Transplant. 1996;17(2):191-6.
Michel, G., Leverger, G., Leblanc, T., Nelken, B., Baruchel, A., Landman-Parker, J., Thuret, I., Bergeron, C., Bordigoni, P., Esperou-Bourdeau, H., Perel, Y., Vannier, J. P., & Schaison, G. (1996). Allogeneic bone marrow transplantation vs aggressive post-remission chemotherapy for children with acute myeloid leukemia in first complete remission. A prospective study from the French Society of Pediatric Hematology and Immunology (SHIP). Bone Marrow Transplantation, 17(2), 191-6.
Michel G, et al. Allogeneic Bone Marrow Transplantation Vs Aggressive Post-remission Chemotherapy for Children With Acute Myeloid Leukemia in First Complete Remission. a Prospective Study From the French Society of Pediatric Hematology and Immunology (SHIP). Bone Marrow Transplant. 1996;17(2):191-6. PubMed PMID: 8640165.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Allogeneic bone marrow transplantation vs aggressive post-remission chemotherapy for children with acute myeloid leukemia in first complete remission. A prospective study from the French Society of Pediatric Hematology and Immunology (SHIP). AU - Michel,G, AU - Leverger,G, AU - Leblanc,T, AU - Nelken,B, AU - Baruchel,A, AU - Landman-Parker,J, AU - Thuret,I, AU - Bergeron,C, AU - Bordigoni,P, AU - Esperou-Bourdeau,H, AU - Perel,Y, AU - Vannier,J P, AU - Schaison,G, PY - 1996/2/1/pubmed PY - 1996/2/1/medline PY - 1996/2/1/entrez SP - 191 EP - 6 JF - Bone marrow transplantation JO - Bone Marrow Transplant VL - 17 IS - 2 N2 - The objective of this study was to compare allogeneic bone marrow transplantation (BMT) with high-dose cytarabine containing chemotherapy in children with acute myeloid leukemia (AML) in first complete remission (CR). One hundred and seventy-one children were enrolled on the LAME89/91 protocol. Induction chemotherapy was a combination of cytarabine and mitoxantrone. After achieving CR, patients who had an HLA-identical sibling donor underwent allogeneic BMT. Children not eligible for BMT received post remission chemotherapy which included two consolidation courses, the second consolidation consisting of high-dose cytarabine with amsacrine and asparaginase. CR was achieved in 149 children (87%). Thirty-two had an HLA-identical sibling donor and were eligible for BMT. These 32 patients, as well as an additional child who had a one antigen HLA-mismatched father, received BMT during first CR. Consequently, 33 patients were analyzed in the BMT group and 116 in the chemotherapy group. The 4-year probability of relapse was 26 +/- 15% in the BMT group and 47 +/- 10% in the chemotherapy group (P = 0.04). The risk of therapy-related death was 3% for BMT and 7.7% for chemotherapy. Disease-free survival (DFS) was 72 +/- 15% in the BMT group and 48 +/- 10% in the chemotherapy group (p = 0.02). We conclude that allogeneic BMT from a matched sibling donor is the treatment of choice for reducing the relapse risk and for increasing DFS in children with AML in first CR. SN - 0268-3369 UR - https://www.unboundmedicine.com/medline/citation/8640165/Allogeneic_bone_marrow_transplantation_vs_aggressive_post_remission_chemotherapy_for_children_with_acute_myeloid_leukemia_in_first_complete_remission__A_prospective_study_from_the_French_Society_of_Pediatric_Hematology_and_Immunology__SHIP__ DB - PRIME DP - Unbound Medicine ER -