title: Bone marrow transplants may cure patients with acute leukemia never achieving remission with chemotherapy.
abstract: About 30% of adults with acute lymphoblastic leukemia (ALL) and 20% to 40% of children and adults with acute myelogenous leukemia (AML) never achieve remission, even with intensive chemotherapy. Most die of resistant leukemia, often within 6 months or less. In this study of 126 patients with resistant ALL or AML, allogeneic bone marrow transplants from HLA-identical siblings produced remissions in 113 of 115 (98%) evaluable patients. The 3-year probability of leukemia-free survival was 21% (95% confidence interval, 15% to 29%). Leukemia-free survival was similar in ALL (23%, 12% to 40%) and AML (21%, 14% to 31%). Only 3 of 27 patients at risk relapsed more than 2 years posttransplant.
authors.affiliation: Department of Medicine, Medical College of Wisconsin, Milwaukee 53226.
authors.forename: J C
authors.initials: JC
authors.lastname: Biggs
authors.forename: M M
authors.initials: MM
authors.lastname: Horowitz
authors.forename: R P
authors.initials: RP
authors.lastname: Gale
authors.forename: R C
authors.initials: RC
authors.lastname: Ash
authors.forename: K
authors.initials: K
authors.lastname: Atkinson
authors.forename: W
authors.initials: W
authors.lastname: Helbig
authors.forename: N
authors.initials: N
authors.lastname: Jacobsen
authors.forename: G L
authors.initials: GL
authors.lastname: Phillips
authors.forename: A A
authors.initials: AA
authors.lastname: Rimm
authors.forename: O
authors.initials: O
authors.lastname: Ringdén
mesh_terms: D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D004351:Drug Resistance; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology / Q000401:mortality; D006801:Humans; D007223:Infant; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D012074:Remission Induction; D015996:Survival Rate