[Allogenic bone marrow grafts in acute myeloid leukemias. A retrospective study in 111 grafted patients in first complete remission].
Between 1978 and 1984, in 13 French Transplant Centers, 111 patients with acute myelogenous leukaemia underwent allogeneic bone marrow transplantation while in first complete remission. The conditioning regimen consisted of cytoxan 60 mg/kg X 2 and 10 Gy total body irradiation. To prevent graft-versus-host disease, 75% of the patients were given methotrexate and 25%, cyclosporine A. The probability of remaining in complete remission was 61% at 5 years. The probability of survival was 43% at 5 years, with a plateau between 2.5 and 6 years. The most frequent causes of death were interstitial pneumonia, relapses and graft-versus-host disease. Relapses were more frequent in cases with M 4-5 cytology than in those with M1 to M3 cytology (P less than 0.01). Transplant-related deaths were mainly consecutive to graft-versus-host disease and its facilitating effect on pneumonia (P less than 0.05). These results indicate that bone marrow transplantation can cure a large proportion of patients with acute myelogenous leukaemia, especially AML subtypes without monocytic differentiation. Improvements in conditioning regimens for the M 4-5 subtypes and in prevention of graft-versus-host reaction and cytomegalovirus infection should give rise to further developments in this field.
D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation; D002648:Child; D002675:Child, Preschool; D006086:Graft vs Host Disease / Q000209:etiology; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000628:therapy*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011014:Pneumonia / Q000209:etiology; D011183:Postoperative Complications / Q000209:etiology; D011379:Prognosis; D012074:Remission Induction; D012189:Retrospective Studies
Greffes de moelle allogéniques dans les leucémies aiguës myéloïdes. Etude rétrospective chez 111 malades greffés en première rémission complète.