Bone marrow transplantation for acute lymphoblastic leukaemia: a survey of the European Group for Bone Marrow Transplantation (E.G.B.M.T.)

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Abstract
Between 1979-1982, 192 patients with acute lymphoblastic leukemia [ALL] were given allogenic bone marrow transplants from HLA-identical siblings. Data on 57 patients transplanted in 1st remission were compared with the results in 96 patients transplanted in 2nd remission and 39 in 3rd or subsequent remission. The majority of these patients were of the non-B non-T-ALL and T-ALL subtypes. The 2-yr actuarial survival of non-B non-T-ALL was 58% for patients transplanted in 1st remission, 34% for 2nd remission patients and 33% for patients tranplanted in 3rd or subsequent remission (P = 0.60). For patients with T-ALL, the survivals at 2 yr for 1st and 2nd remission transplant patients were 61% and 10%, respectively (P = 0.04). Multifactorial analysis demonstrated a significantly higher probability of survival for patients grafted in 1st remission (compared with more advanced remission states) and with bone marrrow from young (age .ltoreq. 20 yr) donors. The 2-yr actuarial risk of relapse for patients with non-B non-T-ALL transplanted in 1st remission was 0%, 32% and 69% for 2nd and 3rd or subsequent remission patients, respectively (P = 0.04). For T-ALL the actuarial risk of relapse at 2 yr is 10% for 1st remission grafts and 48% for 2nd remission grafts (P = 0.07). Only patients (with both non-B non-T-/and T-ALL) transplanted in 1st remission have a high and stable probability of remaining in remission.