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A comparison of marrow transplantation with chemotherapy for children with acute lymphoblastic leukemia in second or subsequent remission.

Abstract
The progress of 24 children with acute lymphoblastic leukemia treated with cyclophosphamide, total-body irradiation, and marrow transplantation during a second or subsequent remission was compared with that of 21 children treated with conventional chemotherapy after they had entered a second remission. Eleven of the transplantation group are alive, including nine in continuing complete remission for 17 to 55 months; only two of the chemotherapy group are alive, one in complete remission after 20 months. Relapse was the major cause of failure in both groups. Acute and chronic graft-versus-host disease in the transplantation group and leukoencephalopathy in both groups were the other major causes of morbidity and mortality. This study demonstrates that marrow transplantation currently offers the best chance of long-term remission and potential cure after a child with acute lymphoblastic leukemia has had a relapse in the marrow.
AuthorsF L Johnson, E D Thomas, B S Clark, R L Chard, J R Hartmann, R Storb
JournalThe New England journal of medicine (N Engl J Med) Vol. 305 Issue 15 Pg. 846-51 (Oct 08 1981) ISSN: 0028-4793 [Print] United States
PMID7024804 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)
Chemical References
  • Antineoplastic Agents
Topics
  • Adolescent
  • Antineoplastic Agents (administration & dosage, therapeutic use)
  • Bone Marrow Transplantation
  • Child
  • Child, Preschool
  • Drug Therapy, Combination
  • Female
  • Graft vs Host Reaction
  • Humans
  • Infant
  • Infections (etiology)
  • Leukemia, Lymphoid (complications, drug therapy, mortality, therapy)
  • Male
  • Recurrence
  • Remission, Spontaneous
  • Time Factors
  • Transplantation, Homologous

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