A comparison of allogeneic bone marrow transplantation, autologous bone marrow transplantation, and aggressive chemotherapy in children with acute myeloid leukemia in remission - PubMed (original) (raw)
Clinical Trial
. 2001 Jan 1;97(1):56-62.
doi: 10.1182/blood.v97.1.56.
Affiliations
- PMID: 11133742
- DOI: 10.1182/blood.v97.1.56
Free article
Clinical Trial
A comparison of allogeneic bone marrow transplantation, autologous bone marrow transplantation, and aggressive chemotherapy in children with acute myeloid leukemia in remission
W G Woods et al. Blood. 2001.
Free article
Abstract
Intensive, myelosuppressive therapy is necessary to maximize outcomes for patients with acute myeloid leukemia (AML). A comparison was made of 3 aggressive postremission approaches for children and adolescents with AML in a randomized trial, CCG-2891. A total of 652 children and adolescents with AML who achieved remission on 2 induction regimens using identical drugs and doses (standard and intensive timing) were eligible for allocation to allogeneic bone marrow transplantation (BMT) based on matched related donor status (n = 181) or randomization to autologous BMT (n = 177) or to aggressive high-dose cytarabine-based chemotherapy (n = 179). Only 115 patients (18%) refused to participate in the postremission phase of this study. Overall compliance with the 3 allocated regimens was 90%. At 8 years actuarial, 54% +/- 4% (95% confidence interval) of all remission patients remain alive. Survival by assigned regimen ("intent to treat") is as follows: allogeneic BMT, 60% +/- 9%; autologous BMT, 48% +/- 8%; and chemotherapy, 53% +/- 8%. Survival in the allogeneic BMT group is significantly superior to autologous BMT (P =.002) and chemotherapy (P =.05); differences between chemotherapy and autologous BMT are not significant (P =.21). No potential confounding factors affected results. Patients receiving intensive-timing induction therapy had superior long-term survival irrespective of postremission regimen received (allogeneic BMT, 70% +/- 9%; autologous BMT, 54% +/- 9%; chemotherapy, 57% +/- 10%). Allogeneic BMT remains the treatment of choice for children and adolescents with AML in remission, when a matched related donor is available. For all others, there is no advantage to autologous BMT; hence, aggressive nonablative chemotherapy should be used.
Comment in
- Intensive chemotherapy versus bone marrow transplantation in pediatric acute myeloid leukemia: a matter of controversies.
Creutzig U, Reinhardt D, Zimmermann M, Klingebiel T, Gadner H. Creutzig U, et al. Blood. 2001 Jun 1;97(11):3671-2; author reply 3674-5. doi: 10.1182/blood.v97.11.3671. Blood. 2001. PMID: 11392327 No abstract available. - Intensive chemotherapy and bone marrow transplantation for children with acute myeloid leukemia.
Horan J, Korones D. Horan J, et al. Blood. 2001 Jun 1;97(11):3672-3; author reply 3674-5. doi: 10.1182/blood.v97.11.3672. Blood. 2001. PMID: 11392328 No abstract available. - Treatment of children with acute myeloid leukemia.
Pinkel D. Pinkel D. Blood. 2001 Jun 1;97(11):3673; author reply 3674-5. doi: 10.1182/blood.v97.11.3673. Blood. 2001. PMID: 11392329 No abstract available.
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