Allogeneic bone marrow transplantation for XXXX during first complete remission.

@entity1 @entity981 @entity2348 @entity1778 @entity2132 @entity401 @entity62 @entity204
@entity1 with @entity981 who have poor prognostic features at diagnosis usually have a short disease-free survival in spite of successful remission induction. Those poor risk features are: age over 30 years, a white blood cell count over 25,000/microliter, certain translocations of chromosomes, and requirement for more than six weeks of induction chemotherapy to attain a complete remission. We have used high-dose radiochemotherapy to prepare 39 @entity1 with @entity981 in first complete remission (1 @entity1 and 38 adults; median age 23 years) for bone marrow transplantation from histocompatible sibling donors. Thirty-one of the 39 @entity1 in this study had one (n = 23) or more (n = 8) poor risk features: age (n = 7); high white blood cell count (n = 19); translocations (n = 4), or resistance to initial induction therapy (n = 11). Currently, 26 @entity1 are surviving for 4-72 months (median 18 months) following marrow grafting and are in complete remission. One of the surviving @entity1 had two marrow transplant procedures because of recurrent @entity1778 . Actuarial survival in complete remission is 63% for the entire group of 39 @entity1 and is 60% if the eight @entity1 who had no poor risk features are excluded from analysis. The following causes for failure were observed: leukemic relapse was encountered in four @entity1 between 3 and 17 months after BMT for an actuarial relapse rate of 16%; @entity2348 was the cause of @entity204 in two @entity1 ; @entity2132 and/or @entity401 led to the demise of seven @entity1 , and one @entity1 died with @entity62 . It appears that high-dose radiochemotherapy followed by bone marrow transplantation from a histocompatible sibling donor during first complete remission can result in a high disease-free survival rate for younger adults with poor-risk @entity981 . This concept needs to be tested in prospective trials comparing bone marrow transplantation with chemotherapy.
