PMID- 2332770
OWN - NLM
STAT- MEDLINE
DCOM- 19900601
LR  - 20170210
IS  - 0732-183X (Print)
IS  - 0732-183X (Linking)
VI  - 8
IP  - 5
DP  - 1990 May
TI  - Allogeneic bone marrow transplantation for patients with high-risk acute 
      lymphoblastic leukemia.
PG  - 820-30
AB  - Seventy-four consecutive patients with high-risk acute lymphoblastic leukemia 
      (ALL) were given cyclophosphamide (CY; 50 mg/kg on each of 4 days) plus total 
      body irradiation (TBI; 300 rad on each of 4 days) followed by a human leukocyte 
      antigen (HLA)-identical allogeneic bone marrow transplant (BMT). Eighteen 
      patients in first complete remission (CR1), 36 in CR2, 16 in CR3, and four in CR4 
      were transplanted. Patients in CR1 were transplanted 1 to 8 months (median, 3 
      months) after attaining CR. All 18 patients in CR1 had one or more poor risk 
      factors: age more than 18 (N = 17), initial leukocyte count greater than or equal 
      to 20,000 (N = 11), Ph 1 chromosome (N = 2), delay in attaining CR more than 6 
      weeks (N = 8), or extramedullary disease (N = 1). Of those transplanted in CR2, 
      72% had relapsed on therapy. The 5-year event-free survival (EFS) rates for 
      patients transplanted in CR1, CR2, and CR3 are 42%, 43%, and 25%, respectively, 
      at median follow-up times of 57, 54, and 72 months, respectively. Children aged 
      less than 18 years transplanted in CR2 have a 5-year EFS rate of 54%. All CR4 
      patients died early after transplant. The actuarial probability of relapse is 
      20%, 26%, and 48% for those transplanted in CR1, CR2, and CR3, respectively. 
      Although there was substantial transplant-associated mortality, it decreased over 
      the decade of the study (P = .01). This study indicates that BMT offers an 
      attractive alternative to postremission chemotherapy in patients in CR1 with poor 
      prognostic factors and in patients in second remission.
FAU - Wingard, J R
AU  - Wingard JR
AD  - Bone Marrow Transplantation Program, Johns Hopkins Oncology Center, Baltimore, MD 
      21205.
FAU - Piantadosi, S
AU  - Piantadosi S
FAU - Santos, G W
AU  - Santos GW
FAU - Saral, R
AU  - Saral R
FAU - Vriesendorp, H M
AU  - Vriesendorp HM
FAU - Yeager, A M
AU  - Yeager AM
FAU - Burns, W H
AU  - Burns WH
FAU - Ambinder, R F
AU  - Ambinder RF
FAU - Braine, H G
AU  - Braine HG
FAU - Elfenbein, G
AU  - Elfenbein G
AU  - et al.
LA  - eng
GR  - CA-06973/CA/NCI NIH HHS/United States
GR  - CA-15396/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, U.S. Gov't, P.H.S.
PL  - United States
TA  - J Clin Oncol
JT  - Journal of clinical oncology : official journal of the American Society of 
      Clinical Oncology
JID - 8309333
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Age Factors
MH  - *Bone Marrow Transplantation/adverse effects/mortality
MH  - Chi-Square Distribution
MH  - Child
MH  - Child, Preschool
MH  - Combined Modality Therapy
MH  - Female
MH  - Humans
MH  - Leukocyte Count
MH  - Male
MH  - Multivariate Analysis
MH  - Philadelphia Chromosome
MH  - Precursor Cell Lymphoblastic Leukemia-Lymphoma/mortality/*surgery/therapy
MH  - Prognosis
MH  - Proportional Hazards Models
MH  - Recurrence
MH  - Remission Induction
MH  - Risk Factors
MH  - Survival Rate
EDAT- 1990/05/01 00:00
MHDA- 1990/05/01 00:01
CRDT- 1990/05/01 00:00
PHST- 1990/05/01 00:00 [pubmed]
PHST- 1990/05/01 00:01 [medline]
PHST- 1990/05/01 00:00 [entrez]
AID - 10.1200/JCO.1990.8.5.820 [doi]
PST - ppublish
SO  - J Clin Oncol. 1990 May;8(5):820-30. doi: 10.1200/JCO.1990.8.5.820.