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- Title
Bone marrow transplantation or chemotherapy after remission induction for adults with acute nonlymphoblastic leukemia. A prospective comparison.
- Authors
Appelbaum, Frederick R.; Dahlberg, Steve; Thomas, Donnall; Buckner, C. Dean; Cheever, Martin A.; Clift, Reginald A.; Crowley, John; Deeg, H. Joachim; Fefer, Alexander; Greenberg, Philip D.; Kadin, Marshall; Smith, Walter; Stewart, Patricia; Sullivan, Keith; Storb, Rainer; Weiden, Paul; Appelbaum, F R; Dahlberg, S; Thomas, E D; Buckner, C D
- Abstract
We compared the outcome of marrow transplantation with that of continued chemotherapy for adults with acute nonlymphoblastic leukemia who achieve a first remission. From May 1977 to July 1982, 111 consecutive adults (ages 17 to 50) with newly diagnosed acute nonlymphoblastic leukemia were treated with induction chemotherapy. Ninety patients (81%) had a complete remission. Forty-four remission patients had available donors: 33 received a transplant and 11 did not. Forty-six patients in remission without matched donors were treated with continued chemotherapy. Kaplan-Meier estimates of 5-year, disease-free survival from complete remission are 49% +/- 18% for the transplant group and 20% +/- 13% for the chemotherapy group. When compared to the chemotherapy group, patients undergoing transplantation had a higher risk of dying during the first 6 months after remission induction but a lower risk of dying thereafter. Within the transplant group, only age influenced survival. Within the chemotherapy group, a leukocyte count of greater than 10 000 mm3 at diagnosis, a French-American-British (FAB) Cooperative Group morphologic status of M-4, M-5, or M-6, and the presence of infection at diagnosis were all associated with shorter survival.
- Subjects
TRANSPLANTATION of organs, tissues, etc.; DRUG therapy; NONLYMPHOID leukemia; LEUKEMIA treatment; CANCER chemotherapy; LEUKEMIA; ANTINEOPLASTIC agents; BONE marrow transplantation; COMBINED modality therapy; DRUG administration; EXPERIMENTAL design; LONGITUDINAL method; REGRESSION analysis; RESEARCH funding; STATISTICAL sampling; HLA-B27 antigen; EVALUATION research; ACUTE diseases; DESCRIPTIVE statistics; KAPLAN-Meier estimator
- Publication
Annals of Internal Medicine, 1984, Vol 101, Issue 5, p581
- ISSN
0003-4819
- Publication type
journal article
- DOI
10.7326/0003-4819-101-5-581