1. Consolidation treatment of adult acute lymphoblastic leukemia: a prospective, randomized trial comparing allogeneic versus autologous bone marrow transplantation and testing the impact of recombinant interleukin-2 after autologous bone marrow transplantation. BGMT Group
- Author
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Jose-Luis Pico, C Sauvage, M. Attal, Didier Blaise, Xavier Troussard, Marie-Cécile Michallet, Gerald Marit, Catherine Payen, Jean-Paul Vernant, and Gerard Nedellec
- Subjects
Adult ,medicine.medical_specialty ,Immunology ,Transplantation, Autologous ,Biochemistry ,Gastroenterology ,Immunophenotyping ,law.invention ,Randomized controlled trial ,HLA Antigens ,law ,Internal medicine ,Acute lymphocytic leukemia ,medicine ,Humans ,Transplantation, Homologous ,Prospective Studies ,Prospective cohort study ,Survival analysis ,Bone Marrow Transplantation ,business.industry ,Cell Biology ,Hematology ,Middle Aged ,Precursor Cell Lymphoblastic Leukemia-Lymphoma ,medicine.disease ,Combined Modality Therapy ,Survival Analysis ,Surgery ,Regimen ,surgical procedures, operative ,medicine.anatomical_structure ,Histocompatibility ,Adult Acute Lymphoblastic Leukemia ,Interleukin-2 ,Bone marrow ,business - Abstract
A prospective, randomized trial was initiated in adult acute lymphoblastic leukemia (ALL) to compare (1) disease-free survival (DFS) after allogeneic or autologous bone marrow transplantation (BMT) and (2) the relapse rate of patients treated with or without interleukin-2 (IL-2) after autologous BMT. A total of 135 previously untreated patients, aged under 55 years, received the Berlin-Frankfurt-Muster (BFM) induction regimen: 126 patients (93%), of which 120 were HLA- typed, achieved complete remission (CR). According to this genetic randomization, patients with (n = 43) or without an HLA-identical sibling (n = 77) were to receive allogeneic or autologous BMT, respectively. The 3-year post-CR probability of DFS was significantly higher in the HLA-identical sibling group than in the non-HLA-identical sibling group (68% v 26%; P < .001). Eligible patients were randomized to receive (n = 30) or not to receive (n = 30) IL-2 after autologous BMT: the 3-year post-BMT probability of continuous CR was similar in both groups (29% v 27%, respectively). We conclude that, in ALL, early allogeneic BMT after the BFM induction regimen is an effective consolidation treatment and that IL-2 does not decrease the high relapse rate observed after autologous BMT.
- Published
- 1995