Bone marrow transplantation for adults with acute leukaemia and 11q23 chromosomal abnormalities.
Adults with acute leukaemia and abnormalities of chromosome 11q23 have a poor prognosis when treated with conventional chemotherapy. To determine whether more intensive therapy can improve outcome for patients with this karyotypic finding, a retrospective analysis of all patients with acute leukaemia and 11q23 abnormalities treated at our centre was performed. 12 patients were treated with conventional chemotherapy alone (CC); 20 patients received high-dose chemo/radiotherapy (HDCT) with autologous (seven patients) or allogeneic (13 patients) bone marrow transplantation (BMT). The treatment-related mortality was 25% [95% Confidence Interval (CI) 7-69%] for the CC group and 46% (CI 25-73%) for the BMT group (P = 0.69). Cumulative risk of leukaemia progression was 89% (CI 61-100%) in the CC patients and 38% (CI 12-69%) in the BMT patients (P = 0.001). The 2-year event-free survival for patients treated with CC was 8% (CI 0-31%) and for patients receiving HDCT and BMT was 34% (CI 14-54%) (P = 0.03). These results confirm that conventional chemotherapy is rarely curative for adults with acute leukaemia and 11q23 abnormalities but that HDCT with BMT can result in long-term survival in a significant proportion of patients.
Forrest
D L
DL
Division of Hematology, British Columbia Cancer Agency, Vancouver Hospital and Health Sciences Centre and the University of British Columbia, Canada.
Nevill
T J
TJ
Horsman
D E
DE
Brockington
D A
DA
Fung
H C
HC
Toze
C L
CL
Conneally
E A
EA
Hogge
D E
DE
Sutherland
H J
HJ
Nantel
S H
SH
Shepherd
J D
JD
Barnett
M J
MJ
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols; D016026:Bone Marrow Transplantation / Q000379:methods* / Q000401:mortality; D002869:Chromosome Aberrations; D002880:Chromosomes, Human, Pair 11 / Q000235:genetics*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007938:Leukemia / Q000235:genetics / Q000532:radiotherapy / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014184:Transplantation, Homologous; D016896:Treatment Outcome