Marrow Transplantation for Acute Nonlymphocytic Leukemia after Treatment with Busulfan and Cyclophosphamide

George W. Santos, Peter J. Tutschka, Ronald Brookmeyer, Rein Saral, William E. Beschorner, Wilma B. Bias, Hayden G. Braine, William H. Burns, Gerald J. Elfenbein, Herbert Kaizer, David Mellits, Lyle L. Sensenbrenner, Robert K. Stuart, Andrew M Yeager

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Abstract

Fifty-one patients with acute nonlymphocytic leukemia (16 with end-stage disease, 17 in second or third remission or in early relapse, and 18 in first remission) were given infusions of HLA-identical sibling marrow after cytoreduction with high doses of busulfan and cyclophosphamide. Actuarial two-year survival rates were 0 per cent, 29 per cent, and 44 per cent, respectively. Twelve patients are still alive and in remission after 327 to 1488 days, with 10 surviving beyond two years. Acute graft-versus-host disease and viral pneumonia were the major causes of death. Leukemic cells failed to clear in one patient with end-stage disease, and a relapse with meningeal leukemia occurred in another. Only one other relapse was seen — in a patient given a transplant during a third remission. Survival was favorably affected by younger age and transplantation during first remission. We conclude that high-dose chemotherapy with busulfan and cyclophosphamide, followed by allogeneic-marrow transplantation, can produce long-term remission of acute leukemia. Chemotherapy with high-dose busulfan and cyclophosphamide before transplantation provides an effective alternative to cyclophosphamide and total-body irradiation before transplantation for the treatment of acute nonlymphocytic leukemia. (N Engl J Med 1983: 309:1347–53.).

Original languageEnglish (US)
Pages (from-to)1347-1353
Number of pages7
JournalNew England Journal of Medicine
Volume309
Issue number22
DOIs
StatePublished - Dec 1 1983
Externally publishedYes

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Busulfan
Acute Myeloid Leukemia
Cyclophosphamide
Transplantation
Bone Marrow
Recurrence
Leukemia
Viral Pneumonia
Drug Therapy
Whole-Body Irradiation
Homologous Transplantation
Graft vs Host Disease
Therapeutics
Siblings
Cause of Death
Survival Rate
Transplants
Survival

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Marrow Transplantation for Acute Nonlymphocytic Leukemia after Treatment with Busulfan and Cyclophosphamide. / Santos, George W.; Tutschka, Peter J.; Brookmeyer, Ronald; Saral, Rein; Beschorner, William E.; Bias, Wilma B.; Braine, Hayden G.; Burns, William H.; Elfenbein, Gerald J.; Kaizer, Herbert; Mellits, David; Sensenbrenner, Lyle L.; Stuart, Robert K.; Yeager, Andrew M.

In: New England Journal of Medicine, Vol. 309, No. 22, 01.12.1983, p. 1347-1353.

Research output: Contribution to journalArticle

Santos, GW, Tutschka, PJ, Brookmeyer, R, Saral, R, Beschorner, WE, Bias, WB, Braine, HG, Burns, WH, Elfenbein, GJ, Kaizer, H, Mellits, D, Sensenbrenner, LL, Stuart, RK & Yeager, AM 1983, 'Marrow Transplantation for Acute Nonlymphocytic Leukemia after Treatment with Busulfan and Cyclophosphamide', New England Journal of Medicine, vol. 309, no. 22, pp. 1347-1353. https://doi.org/10.1056/NEJM198312013092202
Santos, George W. ; Tutschka, Peter J. ; Brookmeyer, Ronald ; Saral, Rein ; Beschorner, William E. ; Bias, Wilma B. ; Braine, Hayden G. ; Burns, William H. ; Elfenbein, Gerald J. ; Kaizer, Herbert ; Mellits, David ; Sensenbrenner, Lyle L. ; Stuart, Robert K. ; Yeager, Andrew M. / Marrow Transplantation for Acute Nonlymphocytic Leukemia after Treatment with Busulfan and Cyclophosphamide. In: New England Journal of Medicine. 1983 ; Vol. 309, No. 22. pp. 1347-1353.
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