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Bone marrow transplantation for childhood acute lymphoblastic leukaemia after marrow relapse
Author(s) -
Vowels Marcus R.,
LamPoTang Reg,
Mameghan Hedy,
Ford David,
Trickett Annette,
White Leslie,
Marshall Glenn,
Brown Rhonda
Publication year - 1990
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.1990.tb125269.x
Subject(s) - medicine , total body irradiation , bone marrow , chemotherapy , acute lymphocytic leukemia , transplantation , surgery , bone marrow transplantation , leukemia , cyclophosphamide , lymphoblastic leukemia
Children with acute lymphoblastic leukaemia in whom relapse in bone marrow occurs have a poor outlook when treated with chemotherapy alone. Twenty‐seven patients with childhood acute lymphoblastic leukaemia were treated for marrow relapse with high‐dose chemotherapy with or without total body irradiation followed by bone marrow transplantation (BMT). Twenty patients received allogeneic marrow from partially or completely matched histocompatible donors. In this group, nine patients (45%) were free of disease with a median follow‐up of 57 months (range, 22 to 126 months) after transplantation, four (20%) died from interstitial pneumonitis and seven (35%) died after a further relapse. Seven patients received autologous marrow collected while they were in remission. In this group, one patient died from infection and six died after a further relapse. We conclude that allogeneic BMT is more effective than autologous transplantation and results in long‐term disease‐free survival in a significant number of patients. New methods are needed to eradicate residual disease in the patient and to purge marrow ex vivo.