Bone marrow transplantation for primary refractory acute leukaemia.
Twenty-four patients with primary resistant acute leukaemia received bone marrow transplants (BMTs) from matched sibling, syngeneic, matched unrelated, or mismatched family donors as treatment for induction failure. Three (12.5%) patients are alive and well 2-10 years after transplantation. Four (16.7%) patients died of transplant-related complications early post-transplant and remission status could not be determined. Two patients did not achieve complete remission (CR) and died of cytomegalovirus pneumonitis 3 months post-transplant. One patient died of graft failure. CR was obtained in 17 of 20 (85%) evaluable patients after BMT. Ten of 17 (58.8%) patients achieving CR died of transplant-related complications 1-10 months post-transplant. Four of 17 (23.5%) patients who had achieved CR relapsed after transplant. We conclude that a high proportion of patients failing to achieve remission with aggressive conventional chemotherapy achieve CR with BMT and a small proportion become long-term survivors.
Mehta
J
J
Leukaemia Unit, Royal Marsden Hospital, Sutton, UK.
Powles
R
R
Horton
C
C
Milan
S
S
Treleaven
J
J
Tait
D
D
Catovsky
D
D
D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D016572:Cyclosporine / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006086:Graft vs Host Disease / Q000517:prevention & control; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000401:mortality / Q000628:therapy*; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000401:mortality / Q000628:therapy*; D011446:Prospective Studies; D012074:Remission Induction; D015996:Survival Rate
D016572:Cyclosporine; D008727:Methotrexate