Bone marrow transplantation versus high-dose cytarabine-based consolidation chemotherapy for acute myelogenous leukemia in first remission

Gary J. Schiller, Stephen D. Nimer, Mary C. Territo, Winston G. Ho, Richard E. Champlin, James L. Gajewski

Research output: Contribution to journalArticle

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Abstract

Purpose: Despite substantial progress in the treatment of acute myeloid leukemia (AML), fewer than 25% of patients survive free of leukemia for more than 5 years without allogeneic bone marrow transplantation (BMT). In this study we analyzed the results of one or more cycles of high-dose cytarabine-based consolidation chemotherapy as compared with allogeneic BMT in first remission. Patients and Methods: The results in 28 adult patients, aged 16 to 45 years, who underwent a closely HLA-matched BMT for AML in first remission were compared with those in 54 consecutive, age-matched, adult patients treated with one or more cycles of high-dose, cytarabine-based consolidation chemotherapy. Results: After a median follow-up of 4 years, the actuarial risk of leukemic relapse was considerably lower in the transplant group than in the group treated with consolidation chemotherapy (32% ± 26% v 60% ± 14%; P = .05). Treatment-related mortality, however, was much higher in the group treated with BMT (32% v 6%, P = .002). The actuarial disease-free survival at 5 years was not significantly different for the two groups (45% ± 24% v 38% ± 14%). Conclusions: Our results show that BMT in first remission AML did not offer a disease-free survival advantage over intensive postremission consolidation chemotherapy. Larger studies are needed to identify patients who might benefit most from BMT.

Original languageEnglish (US)
Pages (from-to)41-46
Number of pages6
JournalJournal of Clinical Oncology
Volume10
Issue number1
StatePublished - 1992
Externally publishedYes

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Consolidation Chemotherapy
Cytarabine
Bone Marrow Transplantation
Acute Myeloid Leukemia
Homologous Transplantation
Disease-Free Survival
Leukemia
Transplants
Recurrence
Mortality
Therapeutics

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Schiller, G. J., Nimer, S. D., Territo, M. C., Ho, W. G., Champlin, R. E., & Gajewski, J. L. (1992). Bone marrow transplantation versus high-dose cytarabine-based consolidation chemotherapy for acute myelogenous leukemia in first remission. Journal of Clinical Oncology, 10(1), 41-46.

Bone marrow transplantation versus high-dose cytarabine-based consolidation chemotherapy for acute myelogenous leukemia in first remission. / Schiller, Gary J.; Nimer, Stephen D.; Territo, Mary C.; Ho, Winston G.; Champlin, Richard E.; Gajewski, James L.

In: Journal of Clinical Oncology, Vol. 10, No. 1, 1992, p. 41-46.

Research output: Contribution to journalArticle

Schiller, GJ, Nimer, SD, Territo, MC, Ho, WG, Champlin, RE & Gajewski, JL 1992, 'Bone marrow transplantation versus high-dose cytarabine-based consolidation chemotherapy for acute myelogenous leukemia in first remission', Journal of Clinical Oncology, vol. 10, no. 1, pp. 41-46.
Schiller, Gary J. ; Nimer, Stephen D. ; Territo, Mary C. ; Ho, Winston G. ; Champlin, Richard E. ; Gajewski, James L. / Bone marrow transplantation versus high-dose cytarabine-based consolidation chemotherapy for acute myelogenous leukemia in first remission. In: Journal of Clinical Oncology. 1992 ; Vol. 10, No. 1. pp. 41-46.
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