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Allogeneic bone marrow transplantation for acute lymphoblastic leukaemia: risk factors and clinical outcome
Article first published online: 12 MAR 2008
DOI: 10.1111/j.1365-2141.1994.tb03253.x
1365-2141/asset/cover.gif?v=1&s=340532f3ee73ba9171e38abd4d7f6a926d117661 "British Journal of Haematology")
Additional Information
How to Cite
Weisdorf, D. J., Woods, W. G., Nesbit, M. E., Uckun, F., Dusenbery, K., Kim, T., Haake, R., Thomas, W., Kersey, J. H. and Ramsay, N. K. C. (1994), Allogeneic bone marrow transplantation for acute lymphoblastic leukaemia: risk factors and clinical outcome. British Journal of Haematology, 86: 62–69. doi: 10.1111/j.1365-2141.1994.tb03253.x
Publication History
- Issue published online: 12 MAR 2008
- Article first published online: 12 MAR 2008
- Received 7 May 1993; accepted for publication 13 August 1993
- Abstract
- References
- Cited By
Keywords:
- allogeneic BMT;
- acute lymphoblastic leukaemia;
- risk factors
We report 12 years’experience with histocompatible, related donor marrow transplantation for 123 patients with acute lymphoblastic leukaemia; 104 
second remission. Four regimens were studied: cyclophosphamide (Cy)+total body irradiation (TBI) (n= 35); Cy + fractionated TBI (n= 45); TBI + high-dose cytarabine (n= 15); and hyperfractionated TBI + Cy (n= 28). 45 patients survive (34 ± 9%: 95% confidence interval) between 1 and 12·7 years (median 7·8 years) following BMT and 29 ± 8% survive leukaemia-free. Significantly improved disease-free survival was observed in patients with an initial WBC < 50 x 109/l (P= 0·02). Conditioning regimens tested yielded similar outcomes, though TBI/cytarabine led to greater treatment associated mortality. Leukaemia relapse was the most frequent cause of failure in 56 ± 11%; median time of relapse 8 months following BMT, none beyond 2·2 years. Relapse was more frequent with higher WBC, shorter initial remission and previous CNS leukaemia. Acute and/or chronic GVHD was associated with a strong trend (P= 0·06) towards less relapse. Allogeneic BMT may be curative for a substantial fraction of patients with ALL, but additional anti-leukaemic measures beyond these conditioning modifications tested will be required to prevent post-transplant leukaemia recurrence.