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Allogeneic bone marrow transplantation for high-risk acute lymphoblastic
leukemia during first complete remission
NJ Chao, SJ Forman, GM Schmidt, DS Snyder, MD Amylon, PN Konrad, AP Nademanee, MR O'Donnell, PM Parker and AS Stein
Department of Medicine and Pediatrics, Stanford University Medical Center,
CA 94305.
Fifty-three patients with high-risk acute lymphoblastic leukemia (ALL)
under age 50 with a histocompatible sibling donor received high-dose
radiochemotherapy followed by allogeneic bone marrow transplantation (BMT).
The high-risk factors used to identify the patients were: white blood cell
count at initial presentation, cytogenetic abnormalities, age,
extramedullary leukemic infiltration, and time from initial therapy to
complete remission. Patients with one or more of the above risk factors who
received BMT have a disease-free survival of 61% with a median follow-up of
66 months (range 11 months to 10.6 years), and an actuarial relapse rate of
10%. This study demonstrates that patients with high-risk ALL achieve a
significant disease-free survival and cure rate with the use of allogeneic
fully matched sibling BMT. However, a properly designed prospective study
comparing the outcome of BMT with the best currently available chemotherapy
data is required to define the ultimate role of BMT in this group of
patients.
Volume 78,
Issue 8,
pp. 1923-1927,
10/15/1991
Copyright © 1991 by The American Society of Hematology
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