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Chemotherapy Compared with Autologous or Allogeneic Bone Marrow Transplantation in the Management of Acute Myeloid Leukemia in First Remission
Open accessAbstract
BACKGROUND: In young adults with acute myeloid leukemia, intensive chemotherapy during the initial remission improves the long-term outcome, but the role of bone marrow transplantation is uncertain. We compared high-dose cytarabine with autologous or allogeneic marrow transplantation during the first remission of acute myeloid leukemia. METHODS: Previously untreated adolescents and adults 16 to 55 years of age who had acute myeloid leukemia received standard induction chemotherapy. After complete remission had been achieved, idarubicin (two days) and cytarabine (five days) were administered. Patients with histocompatible siblings were offered allogeneic marrow transplantation, whereas the remaining patients were randomly assigned to receive a single course of high-dose cytarabine or transplantation of autologous marrow treated with perfosfamide (4-hydroperoxycyclophosphamide). Oral busulfan and intravenous cyclophosphamide were used as preparative regimens for both allogeneic and autologous marrow transplantation. The end points were survival from the time of complete remission and disease-free survival. RESULTS: In an intention-to-treat analysis, we found no significant differences in disease-free survival among patients receiving high-dose chemotherapy, those undergoing autologous bone marrow transplantation, and those undergoing allogeneic marrow transplantation. The median follow-up was four years. Survival after complete remission was somewhat better after chemotherapy than after autologous marrow transplantation (P=0.05). There was a marginal advantage in terms of overall survival with chemotherapy as compared with allogeneic marrow transplantation (P=0.04). CONCLUSIONS: A postinduction course of high-dose cytarabine can provide equivalent disease-free survival and somewhat better overall survival than autologous marrow transplantation in adults with acute myeloid leukemia.
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Cited by
Milligan, D. W., Wheatley, K., Littlewood, T., Craig, J. I. O., Burnett, A. K., & for the NCRI Haematological Oncology Clinical Studies Group (2006) · Blood · doi:10.1182/blood-2005-10-4202 · Cited by 141
The Impact of Inflammation-Induced Tumor Plasticity during Myeloid Transformation
Yeaton, A., Cayanan, G., Loghavi, S., Dolgalev, I., Leddin, E. M., Loo, C. E., Torabifard, H., Nicolet, D., Wang, J., Corrigan, K., et al. (2022) · Cancer Discovery · doi:10.1158/2159-8290.cd-21-1146 · Cited by 94
Metadata
- Authors
- Cassileth, P. A., Harrington, D. P., Appelbaum, F. R., Lazarus, H. M., Rowe, J. M., Paietta, E., Willman, C., Hurd, D. D., Bennett, J. M., Blume, K. G., Head, D. R., & Wiernik, P. H.
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 1998-12-03
- Volume
- 339
- Issue
- 23
- Pages
- 1649-1656
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2315152253
- Cited by
- 609
- References
- 0
- FWCI
- 20.12
- Type
- journal article
- Language
- en
- Open access
- bronze
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- CoChat. (2026). Citation check: Chemotherapy Compared with Autologous or Allogeneic Bone Marrow Transplantation in the Management of Acute Myeloid Leukemia in First Remission. https://app.cochat.ai/papers/10.1056/nejm199812033392301
- The paper
- Cassileth, P. A., Harrington, D. P., Appelbaum, F. R., Lazarus, H. M., Rowe, J. M., Paietta, E., Willman, C., Hurd, D. D., Bennett, J. M., Blume, K. G., Head, D. R., & Wiernik, P. H. (1998). Chemotherapy Compared with Autologous or Allogeneic Bone Marrow Transplantation in the Management of Acute Myeloid Leukemia in First Remission. New England Journal of Medicine. https://doi.org/10.1056/nejm199812033392301
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.
