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Splenic irradiation before hematopoietic stem cell transplantation for chronic myeloid leukemia: long-term follow-up of a prospective randomized study.

Abstract：

:In the context of discussions on the reproducibility of clinical studies, we reanalyzed a prospective randomized study on the role of splenic irradiation as adjunct to the conditioning for hematopoietic stem cell transplantation (HSCT) for chronic myeloid leukemia (CML). Between 1986 and 1989, a total of 229 patients with CML were randomized; of these, 225 (98 %; 112 with, 113 without splenic irradiation) could be identified in the database and their survival updated. Results confirmed the early findings with no significant differences in all measured endpoints (overall survival at 25 years: 42.7 %, 32.0-52.4 % vs 52.9 %, 43.2-62.6 %; p = 0.355, log rank test). Additional splenic irradiation failed to reduce relapse incidence. It did not increase non-relapse mortality nor the risk of late secondary malignancies. Comforting are the long-term results from this predefined consecutive cohort of patients: more than 60 % were alive at plus 25 years when they were transplanted with a low European Society for Blood and Marrow Transplantation (EBMT) risk sore. This needs to be considered today when treatment options are discussed for patients who failed initial tyrosine kinase inhibitor therapy and have an available low risk HLA-identical donor.

journal_name

Ann Hematol

journal_title

Annals of hematology

authors

Gratwohl A,Iacobelli S,Bootsman N,van Biezen A,Baldomero H,Arcese W,Arnold R,Bron D,Cordonnier C,Ernst P,Ferrant A,Frassoni F,Gahrton G,Richard C,Kolb HJ,Link H,Niederwieser D,Ruutu T,Schattenberg A,Schmitz N,Torr

doi

10.1007/s00277-016-2638-6

subject

Has Abstract

pub_date

2016-05-01 00:00:00

pages

967-72

issue

6

eissn

0939-5555

issn

1432-0584

pii

10.1007/s00277-016-2638-6

journal_volume

95

pub_type

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