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Medline ® Abstract for Reference 54

of 'Treatment of relapsed or refractory acute lymphoblastic leukemia in adults'

Allogeneic bone marrow transplantation as therapy for primary induction failure for patients with acute leukemia.
Forman SJ, Schmidt GM, Nademanee AP, Amylon MD, Chao NJ, Fahey JL, Konrad PN, Margolin KA, Niland JC, O'Donnell MR
J Clin Oncol. 1991;9(9):1570.
The survival of patients with acute leukemia who do not achieve a remission with primary therapy is very poor. High-dose chemoradiotherapy followed by allogeneic bone marrow transplantation (BMT) has been shown to be effective therapy for patients with acute and chronic leukemia. Therefore, we determined the long-term disease-free survival of patients who did not achieve a remission and were then treated with high-dose therapy and bone marrow allografting from matched sibling donors. Twenty-one patients (median age, 28 years) who did not achieve a remission with induction chemotherapy were subsequently treated with allogeneic BMT. After BMT, 90% achieved a complete remission. Six died of complications of the therapy, and six patients relapsed between 27 and 448 days after BMT. Nine patients (43%; median age, 25 years) are alive between 556 and 4,174 days after BMT. The cumulative probability of disease-free survival at 10 years is 43%. This study suggests that allogeneic BMT can be an effective therapy to achieve long-term control of acute leukemia, even in those patients who do not achieve a remission with primary therapy.
Department of Hematology, City of Hope National Medical Center, Duarte, CA 91010.