High-dose etoposide, cyclophosphamide, and total body irradiation with allogeneic bone marrow transplantation for patients with acute myeloid leukemia in untreated first relapse: A study by the North American Marrow Transplant Group

R. A. Brown, S. N. Wolff, J. W. Fay, L. Pineiro, R. H. Collins, J. P. Lynch, D. Stevens, J. Greer, R. H. Herzig, G. P. Herzig

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Abstract

Relapse is a major cause of treatment failure following allogeneic bone marrow transplantation (BMT) for acute myeloid leukemia (AML). To reduce the risk of relapse following BMT for patients with hematologic malignancy, our group developed a novel preparative regimen which combines high-dose etoposide with cyclophosphamide and total body irradiation (VPCyTBI). We now report the outcome of therapy with VPCyTBI followed by allogeneic BMT for 40 patients with AML in untreated first relapse. With the exception of increased stomatitis, the toxicity of this regimen was similar to that reported by others for CyTBI. Forty-four months after transplant the actuarial probabilities of disease-free survival (DFS), persistent or recurrent leukemia, and transplant related mortality were .29, .44, and .47 respectively. DFS was improved (P < .01) and risk of persistent or recurrent leukemia reduced (P = .005) among patients with significant (grade ≥ 2) acute GVHD. Patients with 30% or more blasts on pre-BMT bone marrow examination were not at increased risk for persistent or recurrent leukemia. We conclude that VPCyTBI with allogeneic BMT is effective therapy for AML in untreated first relapse and that a randomized trial comparing this regimen with CyTBI is warranted.

Original languageEnglish (US)
Pages (from-to)1391-1395
Number of pages5
JournalBlood
Volume85
Issue number5
StatePublished - Mar 1 1995

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Transplants
Whole-Body Irradiation
Homologous Transplantation
Etoposide
Bone Marrow Transplantation
Acute Myeloid Leukemia
Cyclophosphamide
Dosimetry
Bone
Bone Marrow
Irradiation
Recurrence
Leukemia
Disease-Free Survival
Bone Marrow Examination
Stomatitis
Hematologic Neoplasms
Treatment Failure
Toxicity
Mortality

ASJC Scopus subject areas

  • Hematology

Cite this

High-dose etoposide, cyclophosphamide, and total body irradiation with allogeneic bone marrow transplantation for patients with acute myeloid leukemia in untreated first relapse : A study by the North American Marrow Transplant Group. / Brown, R. A.; Wolff, S. N.; Fay, J. W.; Pineiro, L.; Collins, R. H.; Lynch, J. P.; Stevens, D.; Greer, J.; Herzig, R. H.; Herzig, G. P.

In: Blood, Vol. 85, No. 5, 01.03.1995, p. 1391-1395.

Research output: Contribution to journalArticle

Brown, R. A. ; Wolff, S. N. ; Fay, J. W. ; Pineiro, L. ; Collins, R. H. ; Lynch, J. P. ; Stevens, D. ; Greer, J. ; Herzig, R. H. ; Herzig, G. P. / High-dose etoposide, cyclophosphamide, and total body irradiation with allogeneic bone marrow transplantation for patients with acute myeloid leukemia in untreated first relapse : A study by the North American Marrow Transplant Group. In: Blood. 1995 ; Vol. 85, No. 5. pp. 1391-1395.
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