Autologous bone marrow transplantation for childhood acute lymphoblastic leukaemia in second remission – long-term follow-up View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2000-03-01

AUTHORS

SJ Vaidya, A Atra, S Bahl, CR Pinkerton, V Calvagna, C Horton, S Milan, V Shepherd, C Brain, J Treleaven, R Powles, D Tait, ST Meller

ABSTRACT

From 1984 to 1996, 31 consecutive children without sibling donors, aged 5–19 years (median 8) with acute lymphoblastic leukaemia (ALL) in second complete remission (CR), received unpurged autologous bone marrow transplantation (ABMT) after melphalan and single fraction total body irradiation (TBI). ABMT was performed using fresh unmanipulated marrow harvested after standard reinduction and consolidation therapy 2–11 months (median 5) after relapse. With a median survival of 2.9 years the probability of survival for all patients in continuing second CR was 45.1% (95% CI, 24%-62%) after 5 years. Regimen-related and non-leukaemia mortality was 7% (95% CI, 2%-26%). The longest time to second relapse from ABMT was 3.1 years. Pituitary and gonadal dysfunction requiring hormonal replacement therapy occurred in the majority of long-term survivors. Twelve patients developed cataracts. ABMT with melphalan/single fraction TBI has proved an effective anti-leukaemia treatment with low regimen-related mortality but significant long-term morbidity. The current approach of allogeneic BMT from an unrelated donor when no sibling donor is available, following conditioning with cyclophosphamide/ fractionated TBI has resulted in a reduced relapse rate and improved short-term overall survival in the treatment of relapsed childhood ALL. However, long-term results are awaited. Bone Marrow Transplantation (2000) 25, 599–603. More... »

PAGES

599-603

Identifiers

URI

http://scigraph.springernature.com/pub.10.1038/sj.bmt.1702214

DOI

http://dx.doi.org/10.1038/sj.bmt.1702214

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1001090544

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/10734293


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40 schema:description From 1984 to 1996, 31 consecutive children without sibling donors, aged 5–19 years (median 8) with acute lymphoblastic leukaemia (ALL) in second complete remission (CR), received unpurged autologous bone marrow transplantation (ABMT) after melphalan and single fraction total body irradiation (TBI). ABMT was performed using fresh unmanipulated marrow harvested after standard reinduction and consolidation therapy 2–11 months (median 5) after relapse. With a median survival of 2.9 years the probability of survival for all patients in continuing second CR was 45.1% (95% CI, 24%-62%) after 5 years. Regimen-related and non-leukaemia mortality was 7% (95% CI, 2%-26%). The longest time to second relapse from ABMT was 3.1 years. Pituitary and gonadal dysfunction requiring hormonal replacement therapy occurred in the majority of long-term survivors. Twelve patients developed cataracts. ABMT with melphalan/single fraction TBI has proved an effective anti-leukaemia treatment with low regimen-related mortality but significant long-term morbidity. The current approach of allogeneic BMT from an unrelated donor when no sibling donor is available, following conditioning with cyclophosphamide/ fractionated TBI has resulted in a reduced relapse rate and improved short-term overall survival in the treatment of relapsed childhood ALL. However, long-term results are awaited. Bone Marrow Transplantation (2000) 25, 599–603.
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