Transplant or chemotherapy in acute myelogenous leukaemia. International Bone Marrow Transplant Registry. Lancet 1989 May 20;1(8647):1119-22
Date
05/20/1989Pubmed ID
2566059Scopus ID
2-s2.0-0024511774 (requires institutional sign-in at Scopus site) 60 CitationsAbstract
It is not known whether chemotherapy or bone-marrow transplantation is the more effective treatment for acute myelogenous leukaemia (AML) in first remission. Consequently, some centres recommend transplants only for patients for whom a poor response to chemotherapy is predicted. To assess how reasonable this strategy is, data from 704 recipients of HLA-identical sibling transplants for AML in first remission were analysed. 5-year leukaemia-free survival (LFS) was 48% (95% confidence interval 43-53%); leukaemia relapse rate was 20% (16-24%). Improved LFS was associated with younger age and lower white blood cell count at diagnosis. These prognostic variables are similar to those reported to affect outcome after chemotherapy. These findings suggest that a strategy of treatment assignment based on risk factor analysis is unlikely to resolve the controversy of transplant versus chemotherapy for AML in first remission.
Author
Mary M. Horowitz MD, MS Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Actuarial AnalysisAdolescent
Adult
Age Factors
Bone Marrow Transplantation
Child
Child, Preschool
Female
Follow-Up Studies
Graft vs Host Disease
Humans
Infant
Leukemia, Myeloid, Acute
Leukocyte Count
Male
Middle Aged
Prognosis
Registries
Remission Induction
Time Factors
