title: Second bone marrow transplantation after leukemia relapse in 11 patients.
abstract: Since June 1977 eight patients with acute leukemia and three with chronic myelogenous leukemia (CML) have undergone cytoreductive therapy prior to a second allogeneic or syngeneic bone marrow transplantation (BMT). The median age was 24 years (range 7-49 years) and the median time to second BMT was 495 days (range 122-1887 days). Prompt hematopoietic recovery was documented in 11/11 patients and verified by cytogenetic analysis in 7/11. Early death (less than 100 days) was the result of sepsis in one, veno-occlusive disease in one and interstitial pneumonitis in two. Of seven patients who survived beyond 1 year, two patients subsequently died, one as a result of acute respiratory failure and one of leukemia relapse. Five are currently disease-free at 8+, 20+, 42+, 49+ and 72+ months after the second BMT. In this patient population which is at high risk for resistant disease and treatment-related toxicity, a second preparative therapy and BMT may offer a durable disease remission with tolerable toxicity.
authors.affiliation: Bone Marrow Transplantation Unit, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205.
authors.forename: J E
authors.initials: JE
authors.lastname: Wagner
authors.forename: G W
authors.initials: GW
authors.lastname: Santos
authors.forename: W H
authors.initials: WH
authors.lastname: Burns
authors.forename: R
authors.initials: R
authors.lastname: Saral
mesh_terms: D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation; D002648:Child; D005069:Evaluation Studies as Topic; D005260:Female; D006086:Graft vs Host Disease; D006801:Humans; D007165:Immunosuppression Therapy; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000601:surgery*; D015470:Leukemia, Myeloid, Acute / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000601:surgery*; D011300:Preoperative Care; D012086:Reoperation