Splenic irradiation before bone marrow transplantation for chronic myeloid leukemia: update of a prospective randomized study

Leuk Lymphoma. 1993:11 Suppl 1:227-31. doi: 10.3109/10428199309047891.

Abstract

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.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Bone Marrow Transplantation* / mortality
  • Child
  • Europe / epidemiology
  • Female
  • Follow-Up Studies
  • Graft Enhancement, Immunologic*
  • Graft Rejection
  • Graft vs Host Disease / epidemiology
  • Humans
  • Leukemia, Myeloid, Chronic-Phase / blood
  • Leukemia, Myeloid, Chronic-Phase / mortality
  • Leukemia, Myeloid, Chronic-Phase / pathology
  • Leukemia, Myeloid, Chronic-Phase / surgery*
  • Leukocyte Count
  • Life Tables
  • Lymphatic Irradiation*
  • Male
  • Middle Aged
  • Platelet Count
  • Prospective Studies
  • Spleen / radiation effects*
  • Survival Analysis
  • Treatment Failure