NEW DEVELOPMENTS IN CLINICAL BONE-MARROW TRANSPLANTATION FOR LEUKEMIA

  • 1 January 1981
    • journal article
    • research article
    • Vol. 111  (50) , 1975-1977
Abstract
Thirty-nine clinical bone marrow transplants (BMT) for leukemia are described. In a historical control series of 18 patients in whom BMT was performed after all chemotherapeutic resources had been exhausted, there is only 1 long-term survivor (5.5%). Eight patients died from GvH [graft-vs.-host] reaction, 6 from interstitial pneumonia and 3 from recurrent leukemia. Since 1979 an attempt has been made to transplant patients under optimal conditions (1st complete remission; cyclosporin-A (CyA) has been used for prophylaxis of GvH reaction instead of MTX [methotrexate]. Eleven patients were transplanted according to the original proposal (AML [acute myelocytic leukemia] and ALL [acute lymphocytic leukemia] in 1st remission, CML [chronic myelocytic leukemia] in chronic phase. Ten have survived without evidence of leukemia (91%); 1 AML died in relapse. Ten patients wre grafted in 2nd or later remissions or early relapse. Five have leukemia-free survival (50%); 1 is living with a relapse. In this group, 3 deaths were due to recurrent leukemia and 1 to CMV [cytomegalovirus]-infection. BMT under optimal circumstances does not involve a risk of early mortality; the chances of recurrent leukemia are reduced. Severe or chronic GvH reaction is not seen under CyA. BMT is the treatment of choice for patients with histocompatible sibling donors.

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