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Allogeneic bone marrow transplantation for acute leukemia refractory to induction chemotherapy
Author(s) -
Zander Axel R.,
Dicke Karel A.,
Keating Michael,
Vellekoop Lijda,
Culbert Steven,
Spitzer Gary,
Kanojia Mahesh,
Jagannath Sundar,
Schell Sylvia,
Hester Jeane,
Ayyar Raji,
Verma Dhermvir,
McCredie Kenneth,
Peters Lester,
Poynton Christopher H.,
Freireich Emil J
Publication year - 1985
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19850915)56:6<1374::aid-cncr2820560626>3.0.co;2-c
Subject(s) - medicine , refractory (planetary science) , leukemia , induction chemotherapy , acute leukemia , chemotherapy , surgery , total body irradiation , transplantation , gastroenterology , cyclophosphamide , physics , astrobiology
This article compares the outcome of 14 patients with primary refractory acute leukemia who underwent bone marrow transplantation from human leukocyte antigen (HLA)‐identical donors with that of 18 age‐matched control patients who received chemotherapy. Complete clearing of leukemia was seen in all 14 transplanted patients. Five of the transplanted patients are alive 98 to 1790 days posttransplant, and four are free of leukemia. Nine patients have died, eight with severe graft‐ versus ‐host disease associated with interstitial pneumonia or systemic infections and one with relapse from chemotherapy‐associated infections. Engraftment was seen in all patients. Severe graft‐ versus ‐host disease (grades III and IV) was seen in ten patients and resolved in three patients following high‐dose corticosteroid treatment. Three of the 18 control patients are alive, none of them in complete remission. It appears that the combination of piperazinedione and total‐body irradiation followed by allogeneic transplant is effective induction treatment for primary refractory acute leukemia and will be considered in the future as first salvage treatment for patients failing induction treatment.