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

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Gratwohl, Alois Iacobelli, Simona Bootsman, Natalia van Biezen, Anja Baldomero, Helen Ferrant, Augustin [UCL]

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.

Document type Article de périodique (Journal article) – Article de recherche
Access type Accès restreint
Publication date 2016
Language Anglais
Journal information "Annals of Hematology" - Vol. 95, no.6, p. 967-972 (2016)
Peer reviewed yes
Publisher Springer ((Germany) Berlin )
issn 0939-5555
e-issn 1432-0584
Publication status Publié
Affiliation UCL - (SLuc) Service d'hématologie
MESH Subject Adolescent ; Male ; Middle Aged ; Prospective Studies ; Spleen ; Time Factors ; Transplantation Conditioning ; Young Adult ; Adult ; Child ; Cohort Studies ; Female ; Follow-Up Studies ; Hematopoietic Stem Cell Transplantation ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Keywords CML ; HSCT ; Long-term follow-up ; Randomized trial ; Splenic irradiation
Links
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Bibliographic reference Gratwohl, Alois ; Iacobelli, Simona ; Bootsman, Natalia ; van Biezen, Anja ; Baldomero, Helen ; et. al. Splenic irradiation before hematopoietic stem cell transplantation for chronic myeloid leukemia: long-term follow-up of a prospective randomized study.. In: Annals of Hematology, Vol. 95, no.6, p. 967-972 (2016)
Permanent URL http://hdl.handle.net/2078.1/184842