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Long-term follow-up of patients undergoing allogeneic bone marrow transplantation for acute myeloid leukemia in first complete remission after cyclophosphamide-total body irradiation and cyclosporine.
Bone Marrow Transplant. 1996 Oct; 18(4):741-6.BM

Abstract

Eighty-five patients (median age 28 years) with acute myeloid leukemia (AML) in first remission underwent allogeneic bone marrow transplantation (BMT) from HLA-identical siblings between 1978 and 1987 after cyclophosphamide and single-fraction total body irradiation with cyclosporine for graft-versus-host disease (GVHD) prophylaxis. The actuarial probabilities of development of acute and chronic GVHD were 57% and 47%, respectively. Twenty-six patients died of transplant-related complications at a median of 3.5 months, and two of unrelated causes. Seventeen patients relapsed at a median of 6.5 months. Forty patients were alive and well at 74-197 months (median 157) after BMT; seven (18%) with limited chronic GVHD requiring therapy. The actuarial 10-year probabilities of transplant-related death, relapse, and disease-free survival were 33%, 25% and 48% respectively. In multivariate analysis, infusion of a lower cell dose, development of GVHD, and age > 35 years were associated with increased transplant-related mortality, donor-recipient ABO incompatibility with a lower relapse rate, and age > 35 years and a lower cell dose with poorer disease-free survival. We conclude that with long-term follow-up, allografting in AML after cyclophosphamide-TBI and cyclosporine has resulted in disease-free survival that is comparable to most currently reported series. Patients who are alive and well 3-4 years after BMT have excellent prospects of long-term survival.

Authors+Show Affiliations

Mehta J
Leukaemia Unit, Royal Marsden Hospital, Surrey, UK.
Powles R
No affiliation info available
Treleaven J
No affiliation info available
Horton C
No affiliation info available
Tait D
No affiliation info available
Meller S
No affiliation info available
Pinkerton CR
No affiliation info available
Middleton G
No affiliation info available
Eisen T
No affiliation info available
Singhal S
No affiliation info available

MeSH

AdolescentAdultAntineoplastic Agents, AlkylatingBone Marrow TransplantationChildChild, PreschoolCombined Modality TherapyCyclophosphamideCyclosporineFemaleFollow-Up StudiesGraft vs Host DiseaseHumansImmunosuppressive AgentsLeukemia, Myeloid, AcuteMaleMiddle AgedRemission InductionSurvival RateTime FactorsTransplantation, HomologousWhole-Body Irradiation

Pub Type(s)

Journal Article

Language

eng

PubMed ID

8899189

Citation

Mehta, J, et al. "Long-term Follow-up of Patients Undergoing Allogeneic Bone Marrow Transplantation for Acute Myeloid Leukemia in First Complete Remission After Cyclophosphamide-total Body Irradiation and Cyclosporine." Bone Marrow Transplantation, vol. 18, no. 4, 1996, pp. 741-6.
Mehta J, Powles R, Treleaven J, et al. Long-term follow-up of patients undergoing allogeneic bone marrow transplantation for acute myeloid leukemia in first complete remission after cyclophosphamide-total body irradiation and cyclosporine. Bone Marrow Transplant. 1996;18(4):741-6.
Mehta, J., Powles, R., Treleaven, J., Horton, C., Tait, D., Meller, S., Pinkerton, C. R., Middleton, G., Eisen, T., & Singhal, S. (1996). Long-term follow-up of patients undergoing allogeneic bone marrow transplantation for acute myeloid leukemia in first complete remission after cyclophosphamide-total body irradiation and cyclosporine. Bone Marrow Transplantation, 18(4), 741-6.
Mehta J, et al. Long-term Follow-up of Patients Undergoing Allogeneic Bone Marrow Transplantation for Acute Myeloid Leukemia in First Complete Remission After Cyclophosphamide-total Body Irradiation and Cyclosporine. Bone Marrow Transplant. 1996;18(4):741-6. PubMed PMID: 8899189.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term follow-up of patients undergoing allogeneic bone marrow transplantation for acute myeloid leukemia in first complete remission after cyclophosphamide-total body irradiation and cyclosporine. AU - Mehta,J, AU - Powles,R, AU - Treleaven,J, AU - Horton,C, AU - Tait,D, AU - Meller,S, AU - Pinkerton,C R, AU - Middleton,G, AU - Eisen,T, AU - Singhal,S, PY - 1996/10/1/pubmed PY - 1996/10/1/medline PY - 1996/10/1/entrez SP - 741 EP - 6 JF - Bone marrow transplantation JO - Bone Marrow Transplant VL - 18 IS - 4 N2 - Eighty-five patients (median age 28 years) with acute myeloid leukemia (AML) in first remission underwent allogeneic bone marrow transplantation (BMT) from HLA-identical siblings between 1978 and 1987 after cyclophosphamide and single-fraction total body irradiation with cyclosporine for graft-versus-host disease (GVHD) prophylaxis. The actuarial probabilities of development of acute and chronic GVHD were 57% and 47%, respectively. Twenty-six patients died of transplant-related complications at a median of 3.5 months, and two of unrelated causes. Seventeen patients relapsed at a median of 6.5 months. Forty patients were alive and well at 74-197 months (median 157) after BMT; seven (18%) with limited chronic GVHD requiring therapy. The actuarial 10-year probabilities of transplant-related death, relapse, and disease-free survival were 33%, 25% and 48% respectively. In multivariate analysis, infusion of a lower cell dose, development of GVHD, and age > 35 years were associated with increased transplant-related mortality, donor-recipient ABO incompatibility with a lower relapse rate, and age > 35 years and a lower cell dose with poorer disease-free survival. We conclude that with long-term follow-up, allografting in AML after cyclophosphamide-TBI and cyclosporine has resulted in disease-free survival that is comparable to most currently reported series. Patients who are alive and well 3-4 years after BMT have excellent prospects of long-term survival. SN - 0268-3369 UR - https://www.unboundmedicine.com/medline/citation/8899189/Long_term_follow_up_of_patients_undergoing_allogeneic_bone_marrow_transplantation_for_acute_myeloid_leukemia_in_first_complete_remission_after_cyclophosphamide_total_body_irradiation_and_cyclosporine_ DB - PRIME DP - Unbound Medicine ER -
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