Long-term results after allogeneic bone marrow transplantation for chronic myelogenous leukemia in chronic phase: A report from the Chronic Leukemia Working Party of the European Group for Blood and Marrow Transplantation

F. Van Rhee, R. M. Szydlo, J. Hermans, A. Devergie, F. Frassoni, W. Arcese, T. De Witte, H. J. Kolb, D. Niederwiser, N. Jacobsen, G. Gahrton, G. Bandini, E. Carreras, A. Bacigalupo, M. Michallet, T. Ruutu, J. Reiffers, J. M. Goldman, J. Apperley

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Abstract

The purpose of this study was to determine the long-term results of allogeneic bone marrow transplantation for chronic myeloid leukemia. A retrospective analysis was carried out of the outcome of 373 consecutive transplants performed at 38 European institutions between 1980 and 1988 and reported to the registry of the European Group for Blood and Marrow Transplantation. All transplants were carried out for first chronic phase of chronic myelogenous leukemia using unmanipulated marow cells from HLA-identical sibling donors. The probability of survival and leukemia-free survival at 8 years were 54% (95% CI: 49-59) and 47% (95% CI: 41-52) respectively. The probabilities of developing acute GVHD (II-IV) at 100 days and chronic GVHD at 4 years after transplant were 47% (95% CI: 41-53) and 52% (95% CI: 46-58) respectively. The probabilities of transplant-related mortality and leukemic relapse 8 years after BMT were 41% (95% CI: 36-48) and 19% (95% CI: 14-25), respectively. Transplant within 12 months of diagnosis was associated with reduced transplant-related mortality (34 vs 45%, P = 0.013) and resulted in improved leukemia-free survival (52 vs 44%, P = 0.03). The probability of relapse was significantly reduced in patients who developed chronic GVHD (RR = 0.33, P = 0.004). The probability of relapse occurring more than 2 years after transplant was increased more than five-fold in patients transplanted from a male donor (RR = 5.5, P = 0.006). Sixty-seven patients in hematologic remission were studied for residual disease by two-step RT/PCR for BCR-ABL mRNA and 61 (91%) tested negative. We conclude that bone marrow transplantation can induce long-term survival in approximately one-half of CML patients; the majority of survivors have no evidence of residual leukemia cells when studied by molecular techniques. The probability of late relapse is increased with use of a male donor.

Original languageEnglish
Pages (from-to)553-560
Number of pages8
JournalBone Marrow Transplantation
Volume20
Issue number7
Publication statusPublished - Oct 1 1997

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Leukemia, Myeloid, Chronic Phase
Homologous Transplantation
Bone Marrow Transplantation
Leukemia
Transplants
Recurrence
Survival
Tissue Donors
Mortality
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Survivors
Registries
Siblings
Polymerase Chain Reaction
Messenger RNA

Keywords

  • BMT
  • CML
  • Long-term outcome

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Long-term results after allogeneic bone marrow transplantation for chronic myelogenous leukemia in chronic phase : A report from the Chronic Leukemia Working Party of the European Group for Blood and Marrow Transplantation. / Van Rhee, F.; Szydlo, R. M.; Hermans, J.; Devergie, A.; Frassoni, F.; Arcese, W.; De Witte, T.; Kolb, H. J.; Niederwiser, D.; Jacobsen, N.; Gahrton, G.; Bandini, G.; Carreras, E.; Bacigalupo, A.; Michallet, M.; Ruutu, T.; Reiffers, J.; Goldman, J. M.; Apperley, J.

In: Bone Marrow Transplantation, Vol. 20, No. 7, 01.10.1997, p. 553-560.

Research output: Contribution to journalArticle

Van Rhee, F, Szydlo, RM, Hermans, J, Devergie, A, Frassoni, F, Arcese, W, De Witte, T, Kolb, HJ, Niederwiser, D, Jacobsen, N, Gahrton, G, Bandini, G, Carreras, E, Bacigalupo, A, Michallet, M, Ruutu, T, Reiffers, J, Goldman, JM & Apperley, J 1997, 'Long-term results after allogeneic bone marrow transplantation for chronic myelogenous leukemia in chronic phase: A report from the Chronic Leukemia Working Party of the European Group for Blood and Marrow Transplantation', Bone Marrow Transplantation, vol. 20, no. 7, pp. 553-560.
Van Rhee, F. ; Szydlo, R. M. ; Hermans, J. ; Devergie, A. ; Frassoni, F. ; Arcese, W. ; De Witte, T. ; Kolb, H. J. ; Niederwiser, D. ; Jacobsen, N. ; Gahrton, G. ; Bandini, G. ; Carreras, E. ; Bacigalupo, A. ; Michallet, M. ; Ruutu, T. ; Reiffers, J. ; Goldman, J. M. ; Apperley, J. / Long-term results after allogeneic bone marrow transplantation for chronic myelogenous leukemia in chronic phase : A report from the Chronic Leukemia Working Party of the European Group for Blood and Marrow Transplantation. In: Bone Marrow Transplantation. 1997 ; Vol. 20, No. 7. pp. 553-560.
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abstract = "The purpose of this study was to determine the long-term results of allogeneic bone marrow transplantation for chronic myeloid leukemia. A retrospective analysis was carried out of the outcome of 373 consecutive transplants performed at 38 European institutions between 1980 and 1988 and reported to the registry of the European Group for Blood and Marrow Transplantation. All transplants were carried out for first chronic phase of chronic myelogenous leukemia using unmanipulated marow cells from HLA-identical sibling donors. The probability of survival and leukemia-free survival at 8 years were 54{\%} (95{\%} CI: 49-59) and 47{\%} (95{\%} CI: 41-52) respectively. The probabilities of developing acute GVHD (II-IV) at 100 days and chronic GVHD at 4 years after transplant were 47{\%} (95{\%} CI: 41-53) and 52{\%} (95{\%} CI: 46-58) respectively. The probabilities of transplant-related mortality and leukemic relapse 8 years after BMT were 41{\%} (95{\%} CI: 36-48) and 19{\%} (95{\%} CI: 14-25), respectively. Transplant within 12 months of diagnosis was associated with reduced transplant-related mortality (34 vs 45{\%}, P = 0.013) and resulted in improved leukemia-free survival (52 vs 44{\%}, P = 0.03). The probability of relapse was significantly reduced in patients who developed chronic GVHD (RR = 0.33, P = 0.004). The probability of relapse occurring more than 2 years after transplant was increased more than five-fold in patients transplanted from a male donor (RR = 5.5, P = 0.006). Sixty-seven patients in hematologic remission were studied for residual disease by two-step RT/PCR for BCR-ABL mRNA and 61 (91{\%}) tested negative. We conclude that bone marrow transplantation can induce long-term survival in approximately one-half of CML patients; the majority of survivors have no evidence of residual leukemia cells when studied by molecular techniques. The probability of late relapse is increased with use of a male donor.",
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AU - Van Rhee, F.

AU - Szydlo, R. M.

AU - Hermans, J.

AU - Devergie, A.

AU - Frassoni, F.

AU - Arcese, W.

AU - De Witte, T.

AU - Kolb, H. J.

AU - Niederwiser, D.

AU - Jacobsen, N.

AU - Gahrton, G.

AU - Bandini, G.

AU - Carreras, E.

AU - Bacigalupo, A.

AU - Michallet, M.

AU - Ruutu, T.

AU - Reiffers, J.

AU - Goldman, J. M.

AU - Apperley, J.

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N2 - The purpose of this study was to determine the long-term results of allogeneic bone marrow transplantation for chronic myeloid leukemia. A retrospective analysis was carried out of the outcome of 373 consecutive transplants performed at 38 European institutions between 1980 and 1988 and reported to the registry of the European Group for Blood and Marrow Transplantation. All transplants were carried out for first chronic phase of chronic myelogenous leukemia using unmanipulated marow cells from HLA-identical sibling donors. The probability of survival and leukemia-free survival at 8 years were 54% (95% CI: 49-59) and 47% (95% CI: 41-52) respectively. The probabilities of developing acute GVHD (II-IV) at 100 days and chronic GVHD at 4 years after transplant were 47% (95% CI: 41-53) and 52% (95% CI: 46-58) respectively. The probabilities of transplant-related mortality and leukemic relapse 8 years after BMT were 41% (95% CI: 36-48) and 19% (95% CI: 14-25), respectively. Transplant within 12 months of diagnosis was associated with reduced transplant-related mortality (34 vs 45%, P = 0.013) and resulted in improved leukemia-free survival (52 vs 44%, P = 0.03). The probability of relapse was significantly reduced in patients who developed chronic GVHD (RR = 0.33, P = 0.004). The probability of relapse occurring more than 2 years after transplant was increased more than five-fold in patients transplanted from a male donor (RR = 5.5, P = 0.006). Sixty-seven patients in hematologic remission were studied for residual disease by two-step RT/PCR for BCR-ABL mRNA and 61 (91%) tested negative. We conclude that bone marrow transplantation can induce long-term survival in approximately one-half of CML patients; the majority of survivors have no evidence of residual leukemia cells when studied by molecular techniques. The probability of late relapse is increased with use of a male donor.

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