Comparison of outcome following allogeneic bone marrow transplantation with cyclophosphamide-total body irradiation versus busulphan-cyclophosphamide conditioning regimens for acute myelogenous leukaemia in first remission

Mark R. Litzow; Waleska S. Pérez; John P. Klein; Brian J. Bolwell; Bruce Camitta; Edward A. Copelan; Robert Peter Gale; Sergio A. Giralt; Armand Keating; Hillard M. Lazarus; David I. Marks; Philip L. McCarthy; Carole B. Miller; Gustavo Milone; H. Grant Prentice; James A. Russell; Kirk R. Schultz; Michael E. Trigg; Daniel J. Weisdorf; Mary M. Horowitz

doi:10.1046/j.1365-2141.2002.03973.x

Comparison of outcome following allogeneic bone marrow transplantation with cyclophosphamide-total body irradiation versus busulphan-cyclophosphamide conditioning regimens for acute myelogenous leukaemia in first remission

Mark R. Litzow, Waleska S. Pérez, John P. Klein, Brian J. Bolwell, Bruce Camitta, Edward A. Copelan, Robert Peter Gale, Sergio A. Giralt, Armand Keating, Hillard M. Lazarus, David I. Marks, Philip L. McCarthy, Carole B. Miller, Gustavo Milone, H. Grant Prentice, James A. Russell, Kirk R. Schultz, Michael E. Trigg, Daniel J. Weisdorf, Mary M. Horowitz

Hematology

Research output: Contribution to journal › Article › peer-review

84 Scopus citations

Abstract

We evaluated transplant-related mortality (TRM), leukaemia relapse, leukaemia-free survival (LFS) and overall survival (OS) in patients receiving busulphan and cyclophosphamide (BuCy) or cyclophosphamide and total body irradiation (CyTBI) prior to allogeneic bone marrow transplantation (BMT) for acute myelogenous leukaemia (AML) in first remission. Outcomes of 381 human leucocyte antigen (HLA)-matched sibling transplants using BuCy were compared with 200 transplants using CyTBI performed between 1988 and 1996. The incidence of hepatic veno-occlusive disease was higher with BuCy (13%) than with CyTBI (6%) (P = 0.009). Risks of acute and chronic GVHD were similar. In multivariate analysis, relapse risk was higher in the BuCy group [relative risk (RR) = 1.72; 95% confidence interval (CI), 1.05-2.81; P = 0.031]. Eleven of 373 evaluable patients in the BuCy group had a central nervous system relapse in contrast to none of 194 evaluable patients in the CyTBI group (P = 0.016). There were no differences in TRM, LFS and OS. CyTBI conditioning may lower relapse risk but produces comparable TRM, LFS and OS to BuCy for HLA-matched sibling transplantation in first remission AML.

Original language	English (US)
Pages (from-to)	1115-1124
Number of pages	10
Journal	British journal of haematology
Volume	119
Issue number	4
DOIs	https://doi.org/10.1046/j.1365-2141.2002.03973.x
State	Published - 2002

Keywords

Acute myelogenous leukaemia
Bone marrow transplantation
Busulphan
Conditioning regimen
Total body irradiation

ASJC Scopus subject areas

Hematology

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Litzow, M. R., Pérez, W. S., Klein, J. P., Bolwell, B. J., Camitta, B., Copelan, E. A., Gale, R. P., Giralt, S. A., Keating, A., Lazarus, H. M., Marks, D. I., McCarthy, P. L., Miller, C. B., Milone, G., Prentice, H. G., Russell, J. A., Schultz, K. R., Trigg, M. E., Weisdorf, D. J., & Horowitz, M. M. (2002). Comparison of outcome following allogeneic bone marrow transplantation with cyclophosphamide-total body irradiation versus busulphan-cyclophosphamide conditioning regimens for acute myelogenous leukaemia in first remission. British journal of haematology, 119(4), 1115-1124. https://doi.org/10.1046/j.1365-2141.2002.03973.x

Comparison of outcome following allogeneic bone marrow transplantation with cyclophosphamide-total body irradiation versus busulphan-cyclophosphamide conditioning regimens for acute myelogenous leukaemia in first remission. / Litzow, Mark R.; Pérez, Waleska S.; Klein, John P. et al.
In: British journal of haematology, Vol. 119, No. 4, 2002, p. 1115-1124.

Research output: Contribution to journal › Article › peer-review

Litzow, MR, Pérez, WS, Klein, JP, Bolwell, BJ, Camitta, B, Copelan, EA, Gale, RP, Giralt, SA, Keating, A, Lazarus, HM, Marks, DI, McCarthy, PL, Miller, CB, Milone, G, Prentice, HG, Russell, JA, Schultz, KR, Trigg, ME, Weisdorf, DJ & Horowitz, MM 2002, 'Comparison of outcome following allogeneic bone marrow transplantation with cyclophosphamide-total body irradiation versus busulphan-cyclophosphamide conditioning regimens for acute myelogenous leukaemia in first remission', British journal of haematology, vol. 119, no. 4, pp. 1115-1124. https://doi.org/10.1046/j.1365-2141.2002.03973.x

Litzow MR, Pérez WS, Klein JP, Bolwell BJ, Camitta B, Copelan EA et al. Comparison of outcome following allogeneic bone marrow transplantation with cyclophosphamide-total body irradiation versus busulphan-cyclophosphamide conditioning regimens for acute myelogenous leukaemia in first remission. British journal of haematology. 2002;119(4):1115-1124. doi: 10.1046/j.1365-2141.2002.03973.x

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title = "Comparison of outcome following allogeneic bone marrow transplantation with cyclophosphamide-total body irradiation versus busulphan-cyclophosphamide conditioning regimens for acute myelogenous leukaemia in first remission",

abstract = "We evaluated transplant-related mortality (TRM), leukaemia relapse, leukaemia-free survival (LFS) and overall survival (OS) in patients receiving busulphan and cyclophosphamide (BuCy) or cyclophosphamide and total body irradiation (CyTBI) prior to allogeneic bone marrow transplantation (BMT) for acute myelogenous leukaemia (AML) in first remission. Outcomes of 381 human leucocyte antigen (HLA)-matched sibling transplants using BuCy were compared with 200 transplants using CyTBI performed between 1988 and 1996. The incidence of hepatic veno-occlusive disease was higher with BuCy (13%) than with CyTBI (6%) (P = 0.009). Risks of acute and chronic GVHD were similar. In multivariate analysis, relapse risk was higher in the BuCy group [relative risk (RR) = 1.72; 95% confidence interval (CI), 1.05-2.81; P = 0.031]. Eleven of 373 evaluable patients in the BuCy group had a central nervous system relapse in contrast to none of 194 evaluable patients in the CyTBI group (P = 0.016). There were no differences in TRM, LFS and OS. CyTBI conditioning may lower relapse risk but produces comparable TRM, LFS and OS to BuCy for HLA-matched sibling transplantation in first remission AML.",

keywords = "Acute myelogenous leukaemia, Bone marrow transplantation, Busulphan, Conditioning regimen, Total body irradiation",

author = "Litzow, {Mark R.} and P{\'e}rez, {Waleska S.} and Klein, {John P.} and Bolwell, {Brian J.} and Bruce Camitta and Copelan, {Edward A.} and Gale, {Robert Peter} and Giralt, {Sergio A.} and Armand Keating and Lazarus, {Hillard M.} and Marks, {David I.} and McCarthy, {Philip L.} and Miller, {Carole B.} and Gustavo Milone and Prentice, {H. Grant} and Russell, {James A.} and Schultz, {Kirk R.} and Trigg, {Michael E.} and Weisdorf, {Daniel J.} and Horowitz, {Mary M.}",

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T1 - Comparison of outcome following allogeneic bone marrow transplantation with cyclophosphamide-total body irradiation versus busulphan-cyclophosphamide conditioning regimens for acute myelogenous leukaemia in first remission

AU - Litzow, Mark R.

AU - Pérez, Waleska S.

AU - Klein, John P.

AU - Bolwell, Brian J.

AU - Camitta, Bruce

AU - Copelan, Edward A.

AU - Gale, Robert Peter

AU - Giralt, Sergio A.

AU - Keating, Armand

AU - Lazarus, Hillard M.

AU - Marks, David I.

AU - McCarthy, Philip L.

AU - Miller, Carole B.

AU - Milone, Gustavo

AU - Prentice, H. Grant

AU - Russell, James A.

AU - Schultz, Kirk R.

AU - Trigg, Michael E.

AU - Weisdorf, Daniel J.

AU - Horowitz, Mary M.

PY - 2002

Y1 - 2002

N2 - We evaluated transplant-related mortality (TRM), leukaemia relapse, leukaemia-free survival (LFS) and overall survival (OS) in patients receiving busulphan and cyclophosphamide (BuCy) or cyclophosphamide and total body irradiation (CyTBI) prior to allogeneic bone marrow transplantation (BMT) for acute myelogenous leukaemia (AML) in first remission. Outcomes of 381 human leucocyte antigen (HLA)-matched sibling transplants using BuCy were compared with 200 transplants using CyTBI performed between 1988 and 1996. The incidence of hepatic veno-occlusive disease was higher with BuCy (13%) than with CyTBI (6%) (P = 0.009). Risks of acute and chronic GVHD were similar. In multivariate analysis, relapse risk was higher in the BuCy group [relative risk (RR) = 1.72; 95% confidence interval (CI), 1.05-2.81; P = 0.031]. Eleven of 373 evaluable patients in the BuCy group had a central nervous system relapse in contrast to none of 194 evaluable patients in the CyTBI group (P = 0.016). There were no differences in TRM, LFS and OS. CyTBI conditioning may lower relapse risk but produces comparable TRM, LFS and OS to BuCy for HLA-matched sibling transplantation in first remission AML.

AB - We evaluated transplant-related mortality (TRM), leukaemia relapse, leukaemia-free survival (LFS) and overall survival (OS) in patients receiving busulphan and cyclophosphamide (BuCy) or cyclophosphamide and total body irradiation (CyTBI) prior to allogeneic bone marrow transplantation (BMT) for acute myelogenous leukaemia (AML) in first remission. Outcomes of 381 human leucocyte antigen (HLA)-matched sibling transplants using BuCy were compared with 200 transplants using CyTBI performed between 1988 and 1996. The incidence of hepatic veno-occlusive disease was higher with BuCy (13%) than with CyTBI (6%) (P = 0.009). Risks of acute and chronic GVHD were similar. In multivariate analysis, relapse risk was higher in the BuCy group [relative risk (RR) = 1.72; 95% confidence interval (CI), 1.05-2.81; P = 0.031]. Eleven of 373 evaluable patients in the BuCy group had a central nervous system relapse in contrast to none of 194 evaluable patients in the CyTBI group (P = 0.016). There were no differences in TRM, LFS and OS. CyTBI conditioning may lower relapse risk but produces comparable TRM, LFS and OS to BuCy for HLA-matched sibling transplantation in first remission AML.

KW - Acute myelogenous leukaemia

KW - Bone marrow transplantation

KW - Busulphan

KW - Conditioning regimen

KW - Total body irradiation

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ER -

Comparison of outcome following allogeneic bone marrow transplantation with cyclophosphamide-total body irradiation versus busulphan-cyclophosphamide conditioning regimens for acute myelogenous leukaemia in first remission

Abstract

Keywords

ASJC Scopus subject areas

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