Bone marrow transplantation for patients with chronic myeloid leukemia

Journal Article · Thu Jan 23 04:00:00 EST 1986 · N.Engl. J. Med.; (United States)

DOI:https://doi.org/10.1056/NEJM198601233140403· OSTI ID:5805586

Goldman, J M; Apperley, J F; Jones, L; Marcus, R; Goolden, A W; Batchelor, R; Hale, G; Waldmann, H; Reid, C D; Hows, J

Between February 1981 and December 1984 we treated 52 patients with chronic myeloid leukemia in the chronic phase and 18 patients with more advanced disease by high-dose chemoradiotherapy followed by allogeneic bone marrow transplantation using marrow cells from HLA-identical sibling donors. In addition, the 40 patients who had not previously undergone splenectomy received radiotherapy to the spleen. To prevent graft versus host disease, cyclosporine was given either alone or in conjunction with donor marrow depleted of T cells. Of the 52 patients treated in the chronic phase, 38 are alive after a median follow-up of 25 months (range, 7 to 50); the actuarial survival at two years was 72%, and the actuarial risk of relapse was 7%. Of the 18 patients with more advanced disease, 4 have survived; the actuarial two-year survival was 18%, and the actuarial risk of relapse was 42%. We conclude that the probability of cure is highest if transplantation is performed while the patient remains in the chronic phase of chronic myeloid leukemia. T-cell depletion may have reduced the incidence and severity of graft versus host disease. The value of irradiation to the spleen before transplantation has not been established.

• Research Organization: Hammersmith Hospital, London, England
• OSTI ID: 5805586
• Journal Information: N.Engl. J. Med.; (United States), Journal Name: N.Engl. J. Med.; (United States) Vol. 4; ISSN NEJMA
• Country of Publication: United States
• Language: English

Related Subjects

550603* -- Medicine-- External Radiation in Therapy-- (1980-)
62 RADIOLOGY AND NUCLEAR MEDICINE
ANIMAL TISSUES
BODY
BONE MARROW
CHEMOTHERAPY
DISEASES
GRAFT-HOST REACTION
HEMATOPOIETIC SYSTEM
HEMIC DISEASES
LEUKEMIA
MEDICINE
NEOPLASMS
NUCLEAR MEDICINE
ORGANS
PATIENTS
RADIOLOGY
RADIOTHERAPY
SPLEEN
SPLENECTOMY
SURGERY
SURVIVAL TIME
THERAPY
TISSUES
TRANSPLANTS