Bone marrow transplantation for adults with acute leukaemia and 11q23 chromosomal abnormalities

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Abstract
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.

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