TY - JOUR
T1 - Marrow Transplantation for Acute Nonlymphocytic Leukemia after Treatment with Busulfan and Cyclophosphamide
AU - Santos, George W.
AU - Tutschka, Peter J.
AU - Brookmeyer, Ronald
AU - Saral, Rein
AU - Beschorner, William E.
AU - Bias, Wilma B.
AU - Braine, Hayden G.
AU - Burns, William H.
AU - Elfenbein, Gerald J.
AU - Kaizer, Herbert
AU - Mellits, David
AU - Sensenbrenner, Lyle L.
AU - Stuart, Robert K.
AU - Yeager, Andrew M.
PY - 1983/12/1
Y1 - 1983/12/1
N2 - Fifty-one patients with acute nonlymphocytic leukemia (16 with end-stage disease, 17 in second or third remission or in early relapse, and 18 in first remission) were given infusions of HLA-identical sibling marrow after cytoreduction with high doses of busulfan and cyclophosphamide. Actuarial two-year survival rates were 0 per cent, 29 per cent, and 44 per cent, respectively. Twelve patients are still alive and in remission after 327 to 1488 days, with 10 surviving beyond two years. Acute graft-versus-host disease and viral pneumonia were the major causes of death. Leukemic cells failed to clear in one patient with end-stage disease, and a relapse with meningeal leukemia occurred in another. Only one other relapse was seen — in a patient given a transplant during a third remission. Survival was favorably affected by younger age and transplantation during first remission. We conclude that high-dose chemotherapy with busulfan and cyclophosphamide, followed by allogeneic-marrow transplantation, can produce long-term remission of acute leukemia. Chemotherapy with high-dose busulfan and cyclophosphamide before transplantation provides an effective alternative to cyclophosphamide and total-body irradiation before transplantation for the treatment of acute nonlymphocytic leukemia. (N Engl J Med 1983: 309:1347–53.).
AB - Fifty-one patients with acute nonlymphocytic leukemia (16 with end-stage disease, 17 in second or third remission or in early relapse, and 18 in first remission) were given infusions of HLA-identical sibling marrow after cytoreduction with high doses of busulfan and cyclophosphamide. Actuarial two-year survival rates were 0 per cent, 29 per cent, and 44 per cent, respectively. Twelve patients are still alive and in remission after 327 to 1488 days, with 10 surviving beyond two years. Acute graft-versus-host disease and viral pneumonia were the major causes of death. Leukemic cells failed to clear in one patient with end-stage disease, and a relapse with meningeal leukemia occurred in another. Only one other relapse was seen — in a patient given a transplant during a third remission. Survival was favorably affected by younger age and transplantation during first remission. We conclude that high-dose chemotherapy with busulfan and cyclophosphamide, followed by allogeneic-marrow transplantation, can produce long-term remission of acute leukemia. Chemotherapy with high-dose busulfan and cyclophosphamide before transplantation provides an effective alternative to cyclophosphamide and total-body irradiation before transplantation for the treatment of acute nonlymphocytic leukemia. (N Engl J Med 1983: 309:1347–53.).
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U2 - 10.1056/NEJM198312013092202
DO - 10.1056/NEJM198312013092202
M3 - Article
C2 - 6355849
AN - SCOPUS:0021035301
SN - 0028-4793
VL - 309
SP - 1347
EP - 1353
JO - New England Journal of Medicine
JF - New England Journal of Medicine
IS - 22
ER -