How should acute lymphoblastic leukaemia relapsing after bone-marrow transplantation be treated?
Barrett, A.J.; Joshi, R.; Tew, C.
Lancet 1(8439): 1188-1191
1985
ISSN/ISBN: 0140-6736 PMID: 2860389 Document Number: 254690
Twenty-one of 63 patients given bone-marrow transplantation (BMT) for acute lymphoblastic leukemia (ALL) relapsed between day 75-1126 after BMT. Nineteen patients were given leukemic induction treatment with standard combination chemotherapy. Seven patients achieved a sustained remission, of whom 5 are alive in remission 88-1240 days after relapse; the 2 other died during a 2nd BMT. Two of the remaining 14 obtained partial remission but all 14 ultimately died with relapsed leukemia. A favorable outcome for ALL relapsing after BMT was predicted by the pace of the disease: the 5 survivors had an interval between diagnosis and 1st relapse of > 2 yr and a disease-free period after BMT of 500 days or more. Further conventional chemotherapy should apparently be used rather than a 2nd marrow transplant to prolong disease-free survival in patients with ALL relapsing after BMT.