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

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http://hdl.handle.net/10138/223988

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Gratwohl , A , Iacobelli , S , Bootsman , N , van Biezen , A , Baldomero , H , Arcese , W , Arnold , R , Bron , D , Cordonnier , C , Ernst , P , Ferrant , A , Frassoni , F , Gahrton , G , Richard , C , Kolb , H J , Link , H , Niederwieser , D , Ruutu , T , Schattenberg , A , Schmitz , N , Torres-Gomez , A , Zwaan , F , Apperley , J , Olavarria , E , Kroeger , N & European Soc Blood Marrow Transpla 2016 , ' Splenic irradiation before hematopoietic stem cell transplantation for chronic myeloid leukemia : long-term follow-up of a prospective randomized study ' Annals of Hematology , vol. 95 , no. 6 , pp. 967-972 . DOI: 10.1007/s00277-016-2638-6

Title: Splenic irradiation before hematopoietic stem cell transplantation for chronic myeloid leukemia : long-term follow-up of a prospective randomized study
Author: Gratwohl, Alois; Iacobelli, Simona; Bootsman, Natalia; van Biezen, Anja; Baldomero, Helen; Arcese, William; Arnold, Renate; Bron, Dominique; Cordonnier, Catherine; Ernst, Peter; Ferrant, Augustin; Frassoni, Francesco; Gahrton, Gosta; Richard, Carlos; Kolb, Hans Jochem; Link, Hartmut; Niederwieser, Dietger; Ruutu, Tapani; Schattenberg, Anton; Schmitz, Norbert; Torres-Gomez, Antonio; Zwaan, Ferry; Apperley, Jane; Olavarria, Eduardo; Kroeger, Nicolaus; European Soc Blood Marrow Transpla
Other contributor: University of Helsinki, Department of Medicine

Date: 2016-05
Language: eng
Number of pages: 6
Belongs to series: Annals of Hematology
ISSN: 0939-5555
DOI: https://doi.org/10.1007/s00277-016-2638-6
URI: http://hdl.handle.net/10138/223988
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.
Subject: HSCT
CML
Splenic irradiation
Randomized trial
Long-term follow-up
BONE-MARROW-TRANSPLANTATION
CHRONIC GRANULOCYTIC-LEUKEMIA
CHRONIC-PHASE
3122 Cancers
3121 Internal medicine
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