Use of cytosine arabinoside and total body irradiation as conditioning for allogeneic marrow transplantation in patients with acute lymphoblastic leukemia: a multicenter survey.

Abstract:

:We report the experience of 14 centers which have used the combination of cytosine arabinoside (ara-C; 24-36 g/m2) and total body irradiation (TBI) to prepare 213 patients with acute lymphoblastic leukemia (ALL) for allogeneic BMT. The overall 3-year disease-free survival (DFS) probability is 38% (95% CI: 31-45%); 75 patients died of complications and 51 relapsed. Multivariate analysis identified three factors independently associated with outcome: age, remission/relapse status and patient-donor relationship. The 3-year DFS probability is 52% (41-63%) for the 106 patients aged 0-11 and 25% (16-33%) for the 104 aged 11+ years; the DFS probability was 54% (34-74%), 41% (32-49%) and 19% (5-33%) for those in first remission, later remissions and relapse respectively. Older patients suffered both more toxic deaths and more relapses than young ones. No other covariate was found to predict for outcome. The results using ara-C-TBI are similar to those achieved using cyclophosphamide plus TBI to prepare ALL patients for BMT, perhaps because a seemingly lower relapse rate is offset by more toxic deaths particularly in older patients. Therapeutic trials should focus on reducing toxicity while maximizing antileukemic efficacy, and should stratify for patient and disease-related factors.

journal_name

Bone Marrow Transplant

authors

Weyman C,Graham-Pole J,Emerson S,August C,Champlin R,Coccia P,Fay J,Harris R,Koch P,Johnson L

subject

Has Abstract,Author List Incomplete

pub_date

1993-01-01 00:00:00

pages

43-50

issue

1

eissn

0268-3369

issn

1476-5365

journal_volume

11

pub_type

临床试验,杂志文章,多中心研究
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    pub_type: 杂志文章,多中心研究,随机对照试验

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    pub_type: 杂志文章

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    doi:

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    pub_type: 杂志文章

    doi:

    authors: Tissot JD,Helg C,Chapuis B,Zubler RH,Jeannet M,Hochstrasser DF,Hohlfeld P,Schneider P

    更新日期:1992-10-01 00:00:00

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    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:

    authors: Schmidt H,Ehninger G,Dopfer R,Waller HD

    更新日期:1987-10-01 00:00:00

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    pub_type: 杂志文章

    doi:

    authors: Katsanis E,Xu Z,Anderson PM,Dancisak BB,Bausero MA,Weisdorf DJ,Blazar BR,Ochoa AC

    更新日期:1994-10-01 00:00:00

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    pub_type: 杂志文章

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    更新日期:2004-06-01 00:00:00

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    pub_type: 杂志文章

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    更新日期:2003-04-01 00:00:00

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    pub_type: 杂志文章

    doi:

    authors: Castagnola E,Dini G,Lanino E,Tasso L,Dallorso S,Garaventa A,Rossi GA,Giacchino R

    更新日期:1995-06-01 00:00:00

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    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:

    authors: Bacigalupo A,Piaggio G,Podesta M,Figari O,Benvenuto F,Sogno G,Tedone E,Raffo MR,Grassia L,Ferrero R

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    pub_type: 杂志文章,多中心研究

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    更新日期:1999-06-01 00:00:00

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    pub_type: 杂志文章

    doi:

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    更新日期:1998-07-01 00:00:00

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    pub_type: 杂志文章

    doi:

    authors: Preti RA,Ahmed T,Ayello J,Helson L,Argani I,Wuest D,Ciavarella D

    更新日期:1992-05-01 00:00:00

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    pub_type: 杂志文章

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    更新日期:2002-04-01 00:00:00

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    pub_type: 临床试验,杂志文章

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    doi:

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    pub_type: 杂志文章

    doi:

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    更新日期:1990-06-01 00:00:00

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    authors: Mathews V,Savani BN

    更新日期:2014-05-01 00:00:00

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    journal_title:Bone marrow transplantation

    pub_type: 临床试验,杂志文章,多中心研究

    doi:

    authors: Lazarus HM,Gray R,Ciobanu N,Winter J,Weiner RS

    更新日期:1994-09-01 00:00:00

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    更新日期:2000-12-01 00:00:00

  • Hematopoietic stem cell transplantation for infantile osteopetrosis.

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    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/sj.bmt.1701474

    authors: Eapen M,Davies SM,Ramsay NK,Orchard PJ

    更新日期:1998-11-01 00:00:00