Chemotherapy for induction of remission of childhood acute myeloid leukemia followed by marrow transplantation or multiagent chemotherapy: A report from the Childrens Cancer Group

Mark E. Nesbit, Jonathan D. Buckley, Stephen A. Feig, James R. Anderson, Beatrice Lampkin, Irwin D. Bernstein, Tae H. Kim, Sergio Piomelli, John H. Kersey, Peter F. Coccia, Richard C. O'Reilly, Charles August, E. Donnall Thomas, G. Denman Hammond

Research output: Contribution to journalArticle

86 Citations (Scopus)

Abstract

Purpose: In an effort to evaluate the usefulness of bone marrow transplantation, the Childrens Cancer Group (CCG) initiated a multiinstitutional study comparing bone marrow transplantation versus chemotherapy after successful induction of remission for previously untreated children and young adults with acute myeloid leukemia. Patients and Methods: From 1979 to 1983, 508 patients were entered onto this study and 490 were treated. After induction, patients with an HLA mixed leukocyte culture (MLC)- compatible sibling underwent bone marrow transplantation. Patients not eligible for bone marrow transplantation were eligible for randomization to two chemotherapy maintenance regimens. All patients undergoing bone marrow transplantation were conditioned with cyclophosphamide and total-body irradiation (TBI). Methotrexate was used to prevent or modify graft-versus- host disease (GVHD). Results: Three hundred eighty-one patients achieved bone marrow remission (78%). Eighty-nine patients had an HLA/MLC-compatible sibling donor and were eligible for bone marrow transplantation, and 252 had no match. Comparison of survival estimates for patients eligible for transplantation versus not eligible at 3 years (52% v 41%), 5 years (50% v 36%), and 8 years (47% v 34%) showed a significant difference in favor of bone marrow transplantation (P < .05). Disease-free survival (DFS) demonstrated similar results. Application of a cure model to the results showed a better outcome for those eligible for transplantation (P = .04). Patients randomized between the two chemotherapy regimens did not show any significant difference between those treated with a continuous maintenance versus a cyclic regimen (P = .16). Conclusion: Children and young adults who successfully achieved a remission with multiple-agent chemotherapy who had an HLA/MLC-compatible donor and were thus eligible for an allogeneic bone marrow transplant had better survival than those not eligible for transplantation.

Original languageEnglish (US)
Pages (from-to)127-135
Number of pages9
JournalJournal of Clinical Oncology
Volume12
Issue number1
DOIs
StatePublished - Jan 1994

Fingerprint

Remission Induction
Acute Myeloid Leukemia
Bone Marrow Transplantation
Transplantation
Bone Marrow
Drug Therapy
Neoplasms
Leukocytes
Siblings
Young Adult
Tissue Donors
Survival
Whole-Body Irradiation
Graft vs Host Disease
Random Allocation
Methotrexate
Cyclophosphamide
Disease-Free Survival
Maintenance
Transplants

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Chemotherapy for induction of remission of childhood acute myeloid leukemia followed by marrow transplantation or multiagent chemotherapy : A report from the Childrens Cancer Group. / Nesbit, Mark E.; Buckley, Jonathan D.; Feig, Stephen A.; Anderson, James R.; Lampkin, Beatrice; Bernstein, Irwin D.; Kim, Tae H.; Piomelli, Sergio; Kersey, John H.; Coccia, Peter F.; O'Reilly, Richard C.; August, Charles; Thomas, E. Donnall; Hammond, G. Denman.

In: Journal of Clinical Oncology, Vol. 12, No. 1, 01.1994, p. 127-135.

Research output: Contribution to journalArticle

Nesbit, ME, Buckley, JD, Feig, SA, Anderson, JR, Lampkin, B, Bernstein, ID, Kim, TH, Piomelli, S, Kersey, JH, Coccia, PF, O'Reilly, RC, August, C, Thomas, ED & Hammond, GD 1994, 'Chemotherapy for induction of remission of childhood acute myeloid leukemia followed by marrow transplantation or multiagent chemotherapy: A report from the Childrens Cancer Group', Journal of Clinical Oncology, vol. 12, no. 1, pp. 127-135. https://doi.org/10.1200/JCO.1994.12.1.127
Nesbit, Mark E. ; Buckley, Jonathan D. ; Feig, Stephen A. ; Anderson, James R. ; Lampkin, Beatrice ; Bernstein, Irwin D. ; Kim, Tae H. ; Piomelli, Sergio ; Kersey, John H. ; Coccia, Peter F. ; O'Reilly, Richard C. ; August, Charles ; Thomas, E. Donnall ; Hammond, G. Denman. / Chemotherapy for induction of remission of childhood acute myeloid leukemia followed by marrow transplantation or multiagent chemotherapy : A report from the Childrens Cancer Group. In: Journal of Clinical Oncology. 1994 ; Vol. 12, No. 1. pp. 127-135.
@article{b2e8598d88424c0d9b4db49f0a4daa08,
title = "Chemotherapy for induction of remission of childhood acute myeloid leukemia followed by marrow transplantation or multiagent chemotherapy: A report from the Childrens Cancer Group",
abstract = "Purpose: In an effort to evaluate the usefulness of bone marrow transplantation, the Childrens Cancer Group (CCG) initiated a multiinstitutional study comparing bone marrow transplantation versus chemotherapy after successful induction of remission for previously untreated children and young adults with acute myeloid leukemia. Patients and Methods: From 1979 to 1983, 508 patients were entered onto this study and 490 were treated. After induction, patients with an HLA mixed leukocyte culture (MLC)- compatible sibling underwent bone marrow transplantation. Patients not eligible for bone marrow transplantation were eligible for randomization to two chemotherapy maintenance regimens. All patients undergoing bone marrow transplantation were conditioned with cyclophosphamide and total-body irradiation (TBI). Methotrexate was used to prevent or modify graft-versus- host disease (GVHD). Results: Three hundred eighty-one patients achieved bone marrow remission (78{\%}). Eighty-nine patients had an HLA/MLC-compatible sibling donor and were eligible for bone marrow transplantation, and 252 had no match. Comparison of survival estimates for patients eligible for transplantation versus not eligible at 3 years (52{\%} v 41{\%}), 5 years (50{\%} v 36{\%}), and 8 years (47{\%} v 34{\%}) showed a significant difference in favor of bone marrow transplantation (P < .05). Disease-free survival (DFS) demonstrated similar results. Application of a cure model to the results showed a better outcome for those eligible for transplantation (P = .04). Patients randomized between the two chemotherapy regimens did not show any significant difference between those treated with a continuous maintenance versus a cyclic regimen (P = .16). Conclusion: Children and young adults who successfully achieved a remission with multiple-agent chemotherapy who had an HLA/MLC-compatible donor and were thus eligible for an allogeneic bone marrow transplant had better survival than those not eligible for transplantation.",
author = "Nesbit, {Mark E.} and Buckley, {Jonathan D.} and Feig, {Stephen A.} and Anderson, {James R.} and Beatrice Lampkin and Bernstein, {Irwin D.} and Kim, {Tae H.} and Sergio Piomelli and Kersey, {John H.} and Coccia, {Peter F.} and O'Reilly, {Richard C.} and Charles August and Thomas, {E. Donnall} and Hammond, {G. Denman}",
year = "1994",
month = "1",
doi = "10.1200/JCO.1994.12.1.127",
language = "English (US)",
volume = "12",
pages = "127--135",
journal = "Journal of Clinical Oncology",
issn = "0732-183X",
publisher = "American Society of Clinical Oncology",
number = "1",

}

TY - JOUR

T1 - Chemotherapy for induction of remission of childhood acute myeloid leukemia followed by marrow transplantation or multiagent chemotherapy

T2 - A report from the Childrens Cancer Group

AU - Nesbit, Mark E.

AU - Buckley, Jonathan D.

AU - Feig, Stephen A.

AU - Anderson, James R.

AU - Lampkin, Beatrice

AU - Bernstein, Irwin D.

AU - Kim, Tae H.

AU - Piomelli, Sergio

AU - Kersey, John H.

AU - Coccia, Peter F.

AU - O'Reilly, Richard C.

AU - August, Charles

AU - Thomas, E. Donnall

AU - Hammond, G. Denman

PY - 1994/1

Y1 - 1994/1

N2 - Purpose: In an effort to evaluate the usefulness of bone marrow transplantation, the Childrens Cancer Group (CCG) initiated a multiinstitutional study comparing bone marrow transplantation versus chemotherapy after successful induction of remission for previously untreated children and young adults with acute myeloid leukemia. Patients and Methods: From 1979 to 1983, 508 patients were entered onto this study and 490 were treated. After induction, patients with an HLA mixed leukocyte culture (MLC)- compatible sibling underwent bone marrow transplantation. Patients not eligible for bone marrow transplantation were eligible for randomization to two chemotherapy maintenance regimens. All patients undergoing bone marrow transplantation were conditioned with cyclophosphamide and total-body irradiation (TBI). Methotrexate was used to prevent or modify graft-versus- host disease (GVHD). Results: Three hundred eighty-one patients achieved bone marrow remission (78%). Eighty-nine patients had an HLA/MLC-compatible sibling donor and were eligible for bone marrow transplantation, and 252 had no match. Comparison of survival estimates for patients eligible for transplantation versus not eligible at 3 years (52% v 41%), 5 years (50% v 36%), and 8 years (47% v 34%) showed a significant difference in favor of bone marrow transplantation (P < .05). Disease-free survival (DFS) demonstrated similar results. Application of a cure model to the results showed a better outcome for those eligible for transplantation (P = .04). Patients randomized between the two chemotherapy regimens did not show any significant difference between those treated with a continuous maintenance versus a cyclic regimen (P = .16). Conclusion: Children and young adults who successfully achieved a remission with multiple-agent chemotherapy who had an HLA/MLC-compatible donor and were thus eligible for an allogeneic bone marrow transplant had better survival than those not eligible for transplantation.

AB - Purpose: In an effort to evaluate the usefulness of bone marrow transplantation, the Childrens Cancer Group (CCG) initiated a multiinstitutional study comparing bone marrow transplantation versus chemotherapy after successful induction of remission for previously untreated children and young adults with acute myeloid leukemia. Patients and Methods: From 1979 to 1983, 508 patients were entered onto this study and 490 were treated. After induction, patients with an HLA mixed leukocyte culture (MLC)- compatible sibling underwent bone marrow transplantation. Patients not eligible for bone marrow transplantation were eligible for randomization to two chemotherapy maintenance regimens. All patients undergoing bone marrow transplantation were conditioned with cyclophosphamide and total-body irradiation (TBI). Methotrexate was used to prevent or modify graft-versus- host disease (GVHD). Results: Three hundred eighty-one patients achieved bone marrow remission (78%). Eighty-nine patients had an HLA/MLC-compatible sibling donor and were eligible for bone marrow transplantation, and 252 had no match. Comparison of survival estimates for patients eligible for transplantation versus not eligible at 3 years (52% v 41%), 5 years (50% v 36%), and 8 years (47% v 34%) showed a significant difference in favor of bone marrow transplantation (P < .05). Disease-free survival (DFS) demonstrated similar results. Application of a cure model to the results showed a better outcome for those eligible for transplantation (P = .04). Patients randomized between the two chemotherapy regimens did not show any significant difference between those treated with a continuous maintenance versus a cyclic regimen (P = .16). Conclusion: Children and young adults who successfully achieved a remission with multiple-agent chemotherapy who had an HLA/MLC-compatible donor and were thus eligible for an allogeneic bone marrow transplant had better survival than those not eligible for transplantation.

UR - http://www.scopus.com/inward/record.url?scp=0028105832&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0028105832&partnerID=8YFLogxK

U2 - 10.1200/JCO.1994.12.1.127

DO - 10.1200/JCO.1994.12.1.127

M3 - Article

C2 - 8270968

AN - SCOPUS:0028105832

VL - 12

SP - 127

EP - 135

JO - Journal of Clinical Oncology

JF - Journal of Clinical Oncology

SN - 0732-183X

IS - 1

ER -