How should acute lymphoblastic leukaemia relapsing after bone-marrow transplantation be treated?
21 of 63 patients given bone-marrow transplantation (BMT) for acute lymphoblastic leukaemia (ALL) relapsed between day 75 and day 1126 after BMT. 19 patients were given leukaemic induction treatment with standard combination chemotherapy. 7 patients achieved a sustained remission, of whom 5 are alive in remission 88-1240 days after relapse; the 2 others died during a second BMT. 2 of the remaining 14 obtained partial remission but all 14 ultimately died with relapsed leukaemia. A favourable outcome for ALL relapsing after BMT was predicted by the pace of the disease: the 5 survivors had an interval between diagnosis and first relapse of more than 2 years and a disease-free period after BMT of 500 days or more. These results indicate that further conventional chemotherapy should be used rather than a second marrow transplant to prolong disease-free survival in patients with ALL relapsing after BMT.
Barrett
A J
AJ
Joshi
R
R
Tew
C
C
D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016026:Bone Marrow Transplantation; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007945:Leukemia, Lymphoid / Q000188:drug therapy / Q000401:mortality / Q000628:therapy*; D008297:Male; D011379:Prognosis; D012008:Recurrence; D013997:Time Factors