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Leukemia-free survival and mortality in patients with refractory or relapsed acute leukemia given marrow transplants from sibling and unrelated donors.

Authors
  • Greinix, H T
  • Reiter, E
  • Keil, F
  • Fischer, G
  • Lechner, K
  • Dieckmann, K
  • Leitner, G
  • Schulenburg, A
  • Hoecker, P
  • Haas, O A
  • Knoebl, P
  • Mannhalter, C
  • Fonatsch, C
  • Hinterberger, W
  • Kalhs, P
Type
Published Article
Journal
Bone Marrow Transplantation
Publisher
Springer Nature
Publication Date
Apr 01, 1998
Volume
21
Issue
7
Pages
673–678
Identifiers
PMID: 9578306
Source
Medline
License
Unknown

Abstract

Between April 1982 and February 1997 39 patients (24 male, 15 female) with refractory acute leukemia and a median age of 31 years (19-51 years) received allogeneic marrow grafts from an HLA-identical sibling (n = 27), HLA-identical unrelated donor (MUD; n = 10) or 1-antigen mismatched unrelated donor (n = 2). Twenty-eight patients had acute myelogenous leukemia and 11 acute lymphoblastic leukemia. For conditioning most patients received total body irradiation combined with cyclophosphamide (n = 23) or etoposide (n = 7). For graft-versus-host disease prophylaxis patients received cyclosporin A (CsA) and methotrexate (MTX) (n = 20), MTX alone (n = 3), CsA and methylprednisone (n = 6), or CsA alone (n = 10), respectively. As of June 1997 probability of leukemia-free survival projected to 3 years after BMT was 14% for patients given sibling marrow grafts and 28% after MUD transplantation. Transplant-related mortality projected to 3 years was 32% after sibling and 37% after MUD marrow grafting. Although not significantly different, probability of relapse projected to 3 years after BMT was lower after MUD at 56% compared to 78% with sibling BMT. Thus, high-dose chemo/radiotherapy followed by allogeneic marrow infusion has a curative potential for patients with refractory leukemia and offers the chance of long-term disease-free survival for some patients.

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