Splenic irradiation before hematopoietic stem cell transplantation for chronic myeloid leukemia: long-term follow-up of a prospective randomized study
Standard
Splenic irradiation before hematopoietic stem cell transplantation for chronic myeloid leukemia: long-term follow-up of a prospective randomized study. / Gratwohl, Alois; Iacobelli, Simona; Bootsman, Natalia; van Biezen, Anja; Baldomero, Helen; Arcese, William; Arnold, Renate; Bron, Dominique; Cordonnier, Catherine; Ernst, Peter; Ferrant, Augustin; Frassoni, Francesco; Gahrton, Gösta; Richard, Carlos; Kolb, Hans Jochem; Link, Hartmut; Niederwieser, Dietger; Ruutu, Tapani; Schattenberg, Anton; Schmitz, Norbert; Torres-Gomez, Antonio; Zwaan, Ferry; Apperley, Jane; Olavarria, Eduardo; Kröger, Nicolaus; Chronic Malignancies Working Party of the European Group for Blood and Marrow Transplantation (EBMT).
In: ANN HEMATOL, Vol. 95, No. 6, 05.2016, p. 967-72.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Splenic irradiation before hematopoietic stem cell transplantation for chronic myeloid leukemia: long-term follow-up of a prospective randomized study
AU - Gratwohl, Alois
AU - Iacobelli, Simona
AU - Bootsman, Natalia
AU - van Biezen, Anja
AU - Baldomero, Helen
AU - Arcese, William
AU - Arnold, Renate
AU - Bron, Dominique
AU - Cordonnier, Catherine
AU - Ernst, Peter
AU - Ferrant, Augustin
AU - Frassoni, Francesco
AU - Gahrton, Gösta
AU - Richard, Carlos
AU - Kolb, Hans Jochem
AU - Link, Hartmut
AU - Niederwieser, Dietger
AU - Ruutu, Tapani
AU - Schattenberg, Anton
AU - Schmitz, Norbert
AU - Torres-Gomez, Antonio
AU - Zwaan, Ferry
AU - Apperley, Jane
AU - Olavarria, Eduardo
AU - Kröger, Nicolaus
AU - Chronic Malignancies Working Party of the European Group for Blood and Marrow Transplantation (EBMT)
PY - 2016/5
Y1 - 2016/5
N2 - In the context of discussions on the reproducibility of clinical studies, we reanalyzed a prospective randomized study on the role of splenic irradiation as adjunct to the conditioning for hematopoietic stem cell transplantation (HSCT) for chronic myeloid leukemia (CML). Between 1986 and 1989, a total of 229 patients with CML were randomized; of these, 225 (98 %; 112 with, 113 without splenic irradiation) could be identified in the database and their survival updated. Results confirmed the early findings with no significant differences in all measured endpoints (overall survival at 25 years: 42.7 %, 32.0-52.4 % vs 52.9 %, 43.2-62.6 %; p = 0.355, log rank test). Additional splenic irradiation failed to reduce relapse incidence. It did not increase non-relapse mortality nor the risk of late secondary malignancies. Comforting are the long-term results from this predefined consecutive cohort of patients: more than 60 % were alive at plus 25 years when they were transplanted with a low European Society for Blood and Marrow Transplantation (EBMT) risk sore. This needs to be considered today when treatment options are discussed for patients who failed initial tyrosine kinase inhibitor therapy and have an available low risk HLA-identical donor.
AB - In the context of discussions on the reproducibility of clinical studies, we reanalyzed a prospective randomized study on the role of splenic irradiation as adjunct to the conditioning for hematopoietic stem cell transplantation (HSCT) for chronic myeloid leukemia (CML). Between 1986 and 1989, a total of 229 patients with CML were randomized; of these, 225 (98 %; 112 with, 113 without splenic irradiation) could be identified in the database and their survival updated. Results confirmed the early findings with no significant differences in all measured endpoints (overall survival at 25 years: 42.7 %, 32.0-52.4 % vs 52.9 %, 43.2-62.6 %; p = 0.355, log rank test). Additional splenic irradiation failed to reduce relapse incidence. It did not increase non-relapse mortality nor the risk of late secondary malignancies. Comforting are the long-term results from this predefined consecutive cohort of patients: more than 60 % were alive at plus 25 years when they were transplanted with a low European Society for Blood and Marrow Transplantation (EBMT) risk sore. This needs to be considered today when treatment options are discussed for patients who failed initial tyrosine kinase inhibitor therapy and have an available low risk HLA-identical donor.
KW - Adolescent
KW - Adult
KW - Child
KW - Cohort Studies
KW - Female
KW - Follow-Up Studies
KW - Hematopoietic Stem Cell Transplantation
KW - Humans
KW - Leukemia, Myelogenous, Chronic, BCR-ABL Positive
KW - Male
KW - Middle Aged
KW - Prospective Studies
KW - Spleen
KW - Time Factors
KW - Transplantation Conditioning
KW - Young Adult
KW - Journal Article
KW - Randomized Controlled Trial
U2 - 10.1007/s00277-016-2638-6
DO - 10.1007/s00277-016-2638-6
M3 - SCORING: Journal article
C2 - 26994010
VL - 95
SP - 967
EP - 972
JO - ANN HEMATOL
JF - ANN HEMATOL
SN - 0939-5555
IS - 6
ER -