No advantage for patients who receive splenic irradiation before bone marrow transplantation for chronic myeloid leukaemia: Results of a prospective randomized study

A. Gratwohl, J. Hermans, A. Biezen v., W. Arcese, T. De Witte, L. Debusscher, P. Ernst, A. Ferrant, F. Frassoni, G. Gahrton, A. Iriondo, H. J. Kolb, H. Link, D. Niederwieser, T. Ruutu, N. Schmitz, W. Siegert, A. Torres-Gomez, J. P. Vernant, F. E. Zwaan

Research output: Contribution to journalArticlepeer-review

Abstract

A total of 239 patients with chronic myeloid leukaemia (CML) in chronic phase awaiting bone marrow transplantation (BMT) from an HLA-identical sibling donor were randomized to receive, as part of their conditioning, splenic irradiation (SI+) or no splenic irradiation (SI-). There was no difference between the SI+ and SI- groups regarding the distribution of age, sex, donor/recipient sex combination and blood counts at diagnosis and at BMT. Survival, leukaemia-free survival (LFS), incidence of transplant-related mortality, incidence of rejection and probability of relapse do not differ between the 117 SI+ and the 118 SI- patients at a median follow-up time of 2.5 years (minimum 0.5 years). LFS at 30 months is 56% (SE 5%) for the SI+ and 51% (SE 6%) for the SI- group (p = 0.65). LFS is better for younger patients (9/l) (p <0.05). It is worst for male recipients of a female marrow (p <0.05). The incidence of graft-versus-host disease grade ≥II was higher in the SI+ group, though not significantly. We conclude that routine splenic irradiation prior to BMT for patients with CML is of no benefit and should not be used as a routine procedure.

Original languageEnglish
Pages (from-to)147-152
Number of pages6
JournalBone Marrow Transplantation
Volume10
Issue number2
Publication statusPublished - 1992

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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