Bone marrow transplantation for good-risk patients with leukemia in a university affiliated hospital.
Of the first 14 patients with acute or chronic leukemia to undergo bone marrow transplantation at our hospital, 9 (64%), all good-risk, are still alive in remission at 18 to 42 months of follow-up (mean, 29 months) with their Karnofsky performance status between 80% and 100%. The conditioning regimen of fractionated-dose irradiation and high-dose chemotherapy eradicated their disease; only two patients relapsed after transplantation. Toxicity was acceptable. Acute graft-versus-host disease developed in six patients (43%) (grade I or II in four, grade IV in two) and progressed to chronic graft-versus-host disease in four. Viral pneumonitis developed in three patients (21%), but none had idiopathic interstitial pneumonitis. The mean hospital charge was $54,355. These preliminary results suggest that good-risk patients with acute or chronic leukemia can be treated with bone marrow transplantation in a university affiliated hospital with appropriate staff and support facilities and achieve results comparable to those in research institutions at a competitive cost.
D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation; D002648:Child; D003131:Combined Modality Therapy; D005260:Female; D006086:Graft vs Host Disease / Q000517:prevention & control; D006785:Hospitals, University; D006801:Humans; D007938:Leukemia / Q000401:mortality / Q000628:therapy*; D007945:Leukemia, Lymphoid / Q000401:mortality / Q000628:therapy; D007951:Leukemia, Myeloid / Q000401:mortality / Q000628:therapy; D015470:Leukemia, Myeloid, Acute / Q000401:mortality / Q000628:therapy; D008297:Male; D012306:Risk