Allogeneic bone marrow transplantation as therapy for primary induction failure for patients with acute leukemia.
The survival of patients with acute leukemia who do not achieve a remission with primary therapy is very poor. High-dose chemoradiotherapy followed by allogeneic bone marrow transplantation (BMT) has been shown to be effective therapy for patients with acute and chronic leukemia. Therefore, we determined the long-term disease-free survival of patients who did not achieve a remission and were then treated with high-dose therapy and bone marrow allografting from matched sibling donors. Twenty-one patients (median age, 28 years) who did not achieve a remission with induction chemotherapy were subsequently treated with allogeneic BMT. After BMT, 90% achieved a complete remission. Six died of complications of the therapy, and six patients relapsed between 27 and 448 days after BMT. Nine patients (43%; median age, 25 years) are alive between 556 and 4,174 days after BMT. The cumulative probability of disease-free survival at 10 years is 43%. This study suggests that allogeneic BMT can be an effective therapy to achieve long-term control of acute leukemia, even in those patients who do not achieve a remission with primary therapy.
Forman
S J
SJ
Department of Hematology, City of Hope National Medical Center, Duarte, CA 91010.
Schmidt
G M
GM
Nademanee
A P
AP
Amylon
M D
MD
Chao
N J
NJ
Fahey
J L
JL
Konrad
P N
PN
Margolin
K A
KA
Niland
J C
JC
O'Donnell
M R
MR
D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation; D002648:Child; D002675:Child, Preschool; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000601:surgery*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000601:surgery*; D011336:Probability; D012074:Remission Induction; D015996:Survival Rate; D014184:Transplantation, Homologous