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

Abstract

Summary. Between 1979 and 1982, 229 patients with acute nonlymphoblastic leukaemia in remission were given allogeneic bone marrow transplants from HLA‐identical siblings. Data on 183 patients transplanted in first complete remission were compared with results of 46 patients transplanted in second or subsequent remission. The 2‐year actuarial survival rate was 53% for patients transplanted in first remission and 36% for patients transplanted in second or subsequent remission (P= 0·02). The probability of survival was related to the age of the patient (P=0·02) and of the donor (P= 0·0002). The 2‐year actuarial leukaemia recurrence rate was 12% for patients transplanted in first remission and 44% for patients in a subsequent remission (P= 0·10). Other factors correlating with a higher probability of relapse after transplantation were the leukaemia subtypes M4 and M5 (P=0·007), cyclosporin A used as prophylaxis of graft‐versus‐host disease (P= 0·008), and the absence of chronic (but not of acute) graft‐versus‐host disease (P= 0·003). These data indicate that prolonged survival can be achieved in approximately 50% of patients with acute nonlymphoblastic leukaemia who receive bone marrow transplants during their first complete remission. But modifications of pre‐ and post‐transplant treatment should be considered to reduce the rate of relapse.