Splenic irradiation before hematopoietic stem cell transplantation for chronic myeloid leukemia: long-term follow-up of a prospective randomized study

Alois Gratwohl, Simona Iacobelli, Natalia Bootsman, Anja van Biezen, Helen Baldomero, William Arcese, Renate Arnold, Dominique Bron, Catherine Cordonnier, Peter Ernst, Augustin Ferrant, Francesco Frassoni, Gösta Gahrton, Carlos Richard, Hans Jochem Kolb, Hartmut Link, Dietger Niederwieser, Tapani Ruutu, Anton Schattenberg, Norbert SchmitzAntonio Torres-Gomez, Ferry Zwaan, Jane Apperley, Eduardo Olavarria, Nicolaus Kröger

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)1-6
Number of pages6
JournalAnnals of Hematology
DOIs
Publication statusAccepted/In press - Mar 19 2016

Keywords

  • CML
  • HSCT
  • Long-term follow-up
  • Randomized trial
  • Splenic irradiation

ASJC Scopus subject areas

  • Hematology

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