21 research outputs found
INCOMPLETE MARROW RECOVERY ASSOCIATED WITH HEPATITIS AFTER SYNGENEIC BONE MARROW TRANSPLANTATION FOR APLASTIC ANAEMIA: SUCCESSFUL TREATMENT WITH SECOND MARROW TRANSPLANTATION WITHOUT PRECONDITIONING
Treatment of advanced acute leukaemia with allogeneic bone marrow transplantation from unrelated donors
Bone marrow transplantation from a histocompatible donor may produce complete remission in patients with induction failure or relapsed acute leukaemia. Through the National Marrow Donor Program, histocompatible bone marrow from unrelated donors has become available for highârisk patients. In this study we analyse the results of matched unrelated bone marrow transplant in 55 patients with highly advanced acute myelogenous and acute lymphoblastic leukaemia. 28 patients with advanced acute lymphoblastic leukaemia and 27 patients with advanced acute myelogenous leukaemia, age 2â51, were treated withy highâdose chemoradiotherapy and transplantation of of 6/6 HLA matched (n= 46) or one antigen mismatched (n= 9) unrelated donor bone marrow. After a median followâup of 36 months, 13 patients remain alive 17â24 months after transplant for a 2âyear actuarial diseaseâfree and overall survival of 23 ± 12% (median diseaseâfree survival 3.5 months). The actuarial risk of relapse is 24 ± 16% at 1 year. Moderate to severe graftâversusâhost disease occurred in 27/47 evaluable patients (57%). Significant prognostic factors for poor leukaemiaâfree survival include age >21, abnormal karyotype, and active leukaemia at the time of transplant. Other pretreatment characteristics such as gender or type of leukaemia were not significant prognostic factors. Our results show that matched unrelated bone marrow transplant for patients with advanced acute bone marrow transplant for patients with advanced acute leukaemia may provide longâterm leukaemiaâfree survival, but transplantârelated complications produce a sigbificant impact on survival with older age and adverse disease characteristics predicting for poor prognosi