Splenic irradiation before bone marrow transplantation for chronic myeloid leukemia: update of a prospective randomized study.
Two hundred and twenty-nine patients with chronic myeloid leukaemia in chronic phase awaiting bone marrow transplantation from an HLA-identical sibling donor were randomized as part of their conditioning, to receive splenic irradiation (SI+, 115 patients), or not (SI-, 114 patients). Both groups were identical in regard to age, sex, donor/recipient sex combination and disease activity. Survival, leukaemia-free survival, incidence of transplant-related mortality, acute and chronic graft versus host disease, incidence of rejection and probability of relapse were not different in either groups at a median follow-up time of 4.5 years (minimum follow-up 2 years). Recovery of peripheral white blood cell counts to 1 x 10(9)/l but not of platelet counts to 50 x 10(9)/l was significantly faster in patients with SI+ (21 vs 24 days). This small benefit does not justify routine splenic irradiation prior to BMT, in CML.
Gratwohl
A
A
Chronic Leukaemia Working Party, European Group for Bone Marrow Transplantation.
Hermans
J
J
Biezen
A V
AV
Arcese
W
W
de Witte
T
T
Debusscher
L
L
Ernst
P
P
Ferrant
A
A
Frassoni
F
F
Gahrton
G
G
D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation / Q000401:mortality; D002648:Child; D005060:Europe / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006082:Graft Enhancement, Immunologic; D006084:Graft Rejection; D006086:Graft vs Host Disease / Q000453:epidemiology; D006801:Humans; D015466:Leukemia, Myeloid, Chronic-Phase / Q000097:blood / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D007958:Leukocyte Count; D015993:Life Tables; D015182:Lymphatic Irradiation; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011446:Prospective Studies; D013154:Spleen / Q000528:radiation effects*; D016019:Survival Analysis; D017211:Treatment Failure