Bone marrow transplantation for acute nonlymphoblastic leukaemia: a survey of the European Group for Bone Marrow Transplantation (E.G.B.M.T.).
Between 1979 and 1982, 229 patients with acute nonlymphoblastic leukaemia in remission were given allogeneic bone marrow transplants from HLA-identical siblings. Data on 183 patients transplanted in first complete remission were compared with results of 46 patients transplanted in second or subsequent remission. The 2-year actuarial survival rate was 53% for patients transplanted in first remission and 36% for patients transplanted in second or subsequent remission (P = 0.02). The probability of survival was related to the age of the patient (P = 0.02) and of the donor (P = 0.0002). The 2-year actuarial leukaemia recurrence rate was 12% for patients transplanted in first remission and 44% for patients in a subsequent remission (P = 0.10). Other factors correlating with a higher probability of relapse after transplantation were the leukaemia subtypes M4 and M5 (P = 0.007), cyclosporin A used as prophylaxis of graft-versus-host disease (P = 0.008), and the absence of chronic (but not of acute) graft-versus-host disease (P = 0.003). These data indicate that prolonged survival can be achieved in approximately 50% of patients with acute nonlymphoblastic leukaemia who receive bone marrow transplants during their first complete remission. But modifications of pre- and post-transplant treatment should be considered to reduce the rate of relapse.
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D016026:Bone Marrow Transplantation; D002648:Child; D002675:Child, Preschool; D005260:Female; D006086:Graft vs Host Disease / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007938:Leukemia / Q000401:mortality / Q000628:therapy*; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D011336:Probability; D011379:Prognosis; D011658:Pulmonary Fibrosis / Q000453:epidemiology; D013997:Time Factors; D014019:Tissue Donors