PMID- 14751924
OWN - NLM
STAT- MEDLINE
DCOM- 20040625
LR  - 20210206
IS  - 0006-4971 (Print)
IS  - 0006-4971 (Linking)
VI  - 103
IP  - 10
DP  - 2004 May 15
TI  - Allogeneic bone marrow transplantation for children with acute myelocytic 
      leukemia in first remission demonstrates a role for graft versus leukemia in the 
      maintenance of disease-free survival.
PG  - 3655-61
AB  - In Children's Cancer Group (CCG) study 2891, patients who were recently diagnosed 
      with acute myelocytic leukemia (AML) were assigned randomly to standard- or 
      intensive-timing induction chemotherapy. Patients in first complete remission 
      (CR1) and who had a human leukocyte antigen (HLA)-identical, related donor or a 
      donor disparate at a single class I or II locus were nonrandomly assigned to 
      receive a bone marrow transplant (BMT) by using oral busulfan (16 mg/kg) and 
      cyclophosphamide (200 mg/kg). Methotrexate only was given for graft-versus-host 
      disease (GVHD) prophylaxis. One hundred fifty patients received transplants. 
      Grade 3 or 4 acute GVHD occurred in 9% of patients. Patients younger than 10 
      years had a lower incidence of grade 3 or 4 GVHD (4.6%) compared with patients 10 
      years or older (17.4%) (P =.044). Disease-free survival (DFS) at 6 years was 67% 
      and 42% for recipients of intensive- and standard-timing induction therapies, 
      respectively. Multivariate analysis showed that receiving intensive-timing 
      induction therapy (P =.027) and having no hepatomegaly at diagnosis (P =.009) was 
      associated with favorable DFS, and grades 3 and 4 acute GVHD were associated with 
      inferior DFS. Multivariate analysis showed that grades 1 or 2 GVHD (P =.008) and 
      no hepatomegaly at diagnosis (P =.014) were associated with improved relapse-free 
      survival (RFS). Our results show that children older than 10 years are at higher 
      risk for developing severe GVHD; acute GVHD is associated with favorable RFS.
FAU - Neudorf, Steven
AU  - Neudorf S
AD  - American Family Life Assurance Company (AFLAC) Cancer Center, Emory 
      University/Children's Healthcare, Atlanta, GA, USA. sneudorf@choc.org
FAU - Sanders, Jean
AU  - Sanders J
FAU - Kobrinsky, Nathan
AU  - Kobrinsky N
FAU - Alonzo, Todd A
AU  - Alonzo TA
FAU - Buxton, Allen B
AU  - Buxton AB
FAU - Gold, Stuart
AU  - Gold S
FAU - Barnard, Dorothy R
AU  - Barnard DR
FAU - Wallace, Joetta D
AU  - Wallace JD
FAU - Kalousek, Dagmar
AU  - Kalousek D
FAU - Lange, Beverly J
AU  - Lange BJ
FAU - Woods, William G
AU  - Woods WG
LA  - eng
GR  - CA 02971/CA/NCI NIH HHS/United States
GR  - CA 03750/CA/NCI NIH HHS/United States
GR  - CA 07306/CA/NCI NIH HHS/United States
GR  - CA 10382/CA/NCI NIH HHS/United States
GR  - CA 11796/CA/NCI NIH HHS/United States
GR  - CA 17829/CA/NCI NIH HHS/United States
GR  - CA 26044/CA/NCI NIH HHS/United States
GR  - CA 26126/CA/NCI NIH HHS/United States
GR  - CA 27678/CA/NCI NIH HHS/United States
GR  - CA 29013/CA/NCI NIH HHS/United States
GR  - CA 29314/CA/NCI NIH HHS/United States
GR  - CA 36015/CA/NCI NIH HHS/United States
GR  - CA 42764/CA/NCI NIH HHS/United States
GR  - CA 61833/CA/NCI NIH HHS/United States
GR  - CA 69274/CA/NCI NIH HHS/United States
GR  - CA 79726/CA/NCI NIH HHS/United States
GR  - CA 79753/CA/NCI NIH HHS/United States
PT  - Clinical Trial
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, Non-P.H.S.
PT  - Research Support, U.S. Gov't, P.H.S.
DEP - 20040129
PL  - United States
TA  - Blood
JT  - Blood
JID - 7603509
RN  - 0 (Antineoplastic Agents)
RN  - 8N3DW7272P (Cyclophosphamide)
RN  - G1LN9045DK (Busulfan)
RN  - YL5FZ2Y5U1 (Methotrexate)
SB  - IM
MH  - Adolescent
MH  - Antineoplastic Agents/*administration & dosage
MH  - Bone Marrow Transplantation/immunology/*methods/mortality
MH  - Busulfan/administration & dosage
MH  - Child
MH  - Child, Preschool
MH  - Cyclophosphamide/administration & dosage
MH  - Disease-Free Survival
MH  - Female
MH  - Graft vs Host Disease/drug therapy/prevention & control
MH  - *Graft vs Leukemia Effect
MH  - Hepatomegaly
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - Leukemia, Myeloid, Acute/complications/mortality/*therapy
MH  - Male
MH  - Methotrexate/administration & dosage
MH  - Remission Induction/methods
MH  - Risk Factors
MH  - Survival Analysis
MH  - Transplantation, Homologous
EDAT- 2004/01/31 05:00
MHDA- 2004/06/26 05:00
CRDT- 2004/01/31 05:00
PHST- 2004/01/31 05:00 [pubmed]
PHST- 2004/06/26 05:00 [medline]
PHST- 2004/01/31 05:00 [entrez]
AID - S0006-4971(20)43646-8 [pii]
AID - 10.1182/blood-2003-08-2705 [doi]
PST - ppublish
SO  - Blood. 2004 May 15;103(10):3655-61. doi: 10.1182/blood-2003-08-2705. Epub 2004 
      Jan 29.