Treatment of advanced acute leukaemia with allogeneic bone marrow transplantation from unrelated donors

G. Schiller, S. A. Feig, M. Territo, M. Wolin, M. Lill, T. Belin, L. Hunt, Stephen D Nimer, R. Champlin, J. Gajewski

Research output: Contribution to journalArticle

49 Citations (Scopus)

Abstract

Bone marrow transplantation from a histocompatible sibling donor may produce complete remission in patients with induction failure or relapsed acute leukaemia. Through the National Marrow Donor Program, histocompatible bone marrow from unrelated donors has become available for high-risk patients. In this study we analyse the results of matched unrelated bone marrow transplant in 55 patients with highly advanced acute myelogenous and acute lymphoblastic leukaemia. 28 patients with advanced acute lymphoblastic leukaemia and 27 patients with advanced acute myelogenous leukaemia, age 2-51, were treated with high-dose chemoradiotherapy and transplantation of 6/6 HLA matched (n = 46) or one antigen mismatched (n = 9) unrelated donor bone marrow. After a median follow-up of 36 months, 13 patients remain alive 17-74 months after transplant for a 2-year actuarial disease-free and overall survival of 23 ± 12% (median disease-free survival 3.5 months). The actuarial risk of relapse is 24 ± 16% at 1 year. Moderate to severe graft-versus-host disease occurred in 27/47 evaluable patients (57%). Significant prognostic factors for poor leukaemia-free survival include age >21, abnormal karyotype, and active leukaemia at the time of transplant. Other pretreatment characteristics such as gender or type of leukaemia were not significant prognostic factors. Our results show that matched unrelated bone marrow transplant for patients with advanced acute leukaemia may provide long-term leukaemia-free survival, but transplant-related complications produce a significant impact on survival with older age and adverse disease characteristics predicting for poor prognosis.

Original languageEnglish
Pages (from-to)72-78
Number of pages7
JournalBritish Journal of Haematology
Volume88
Issue number1
StatePublished - Jan 1 1994
Externally publishedYes

Fingerprint

Unrelated Donors
Homologous Transplantation
Bone Marrow Transplantation
Leukemia
Bone Marrow
Transplants
Therapeutics
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Disease-Free Survival
Survival
Tissue Donors
Abnormal Karyotype
Chemoradiotherapy
Graft vs Host Disease
Acute Myeloid Leukemia
Siblings
Transplantation
Antigens
Recurrence

Keywords

  • Acute leukaemia
  • Allogeneic BMT
  • Relapsing
  • Resistant
  • Unrelated donor

ASJC Scopus subject areas

  • Hematology

Cite this

Schiller, G., Feig, S. A., Territo, M., Wolin, M., Lill, M., Belin, T., ... Gajewski, J. (1994). Treatment of advanced acute leukaemia with allogeneic bone marrow transplantation from unrelated donors. British Journal of Haematology, 88(1), 72-78.

Treatment of advanced acute leukaemia with allogeneic bone marrow transplantation from unrelated donors. / Schiller, G.; Feig, S. A.; Territo, M.; Wolin, M.; Lill, M.; Belin, T.; Hunt, L.; Nimer, Stephen D; Champlin, R.; Gajewski, J.

In: British Journal of Haematology, Vol. 88, No. 1, 01.01.1994, p. 72-78.

Research output: Contribution to journalArticle

Schiller, G, Feig, SA, Territo, M, Wolin, M, Lill, M, Belin, T, Hunt, L, Nimer, SD, Champlin, R & Gajewski, J 1994, 'Treatment of advanced acute leukaemia with allogeneic bone marrow transplantation from unrelated donors', British Journal of Haematology, vol. 88, no. 1, pp. 72-78.
Schiller G, Feig SA, Territo M, Wolin M, Lill M, Belin T et al. Treatment of advanced acute leukaemia with allogeneic bone marrow transplantation from unrelated donors. British Journal of Haematology. 1994 Jan 1;88(1):72-78.
Schiller, G. ; Feig, S. A. ; Territo, M. ; Wolin, M. ; Lill, M. ; Belin, T. ; Hunt, L. ; Nimer, Stephen D ; Champlin, R. ; Gajewski, J. / Treatment of advanced acute leukaemia with allogeneic bone marrow transplantation from unrelated donors. In: British Journal of Haematology. 1994 ; Vol. 88, No. 1. pp. 72-78.
@article{ed83667c4fd149e38ba25666e01a9b86,
title = "Treatment of advanced acute leukaemia with allogeneic bone marrow transplantation from unrelated donors",
abstract = "Bone marrow transplantation from a histocompatible sibling donor may produce complete remission in patients with induction failure or relapsed acute leukaemia. Through the National Marrow Donor Program, histocompatible bone marrow from unrelated donors has become available for high-risk patients. In this study we analyse the results of matched unrelated bone marrow transplant in 55 patients with highly advanced acute myelogenous and acute lymphoblastic leukaemia. 28 patients with advanced acute lymphoblastic leukaemia and 27 patients with advanced acute myelogenous leukaemia, age 2-51, were treated with high-dose chemoradiotherapy and transplantation of 6/6 HLA matched (n = 46) or one antigen mismatched (n = 9) unrelated donor bone marrow. After a median follow-up of 36 months, 13 patients remain alive 17-74 months after transplant for a 2-year actuarial disease-free and overall survival of 23 ± 12{\%} (median disease-free survival 3.5 months). The actuarial risk of relapse is 24 ± 16{\%} at 1 year. Moderate to severe graft-versus-host disease occurred in 27/47 evaluable patients (57{\%}). Significant prognostic factors for poor leukaemia-free survival include age >21, abnormal karyotype, and active leukaemia at the time of transplant. Other pretreatment characteristics such as gender or type of leukaemia were not significant prognostic factors. Our results show that matched unrelated bone marrow transplant for patients with advanced acute leukaemia may provide long-term leukaemia-free survival, but transplant-related complications produce a significant impact on survival with older age and adverse disease characteristics predicting for poor prognosis.",
keywords = "Acute leukaemia, Allogeneic BMT, Relapsing, Resistant, Unrelated donor",
author = "G. Schiller and Feig, {S. A.} and M. Territo and M. Wolin and M. Lill and T. Belin and L. Hunt and Nimer, {Stephen D} and R. Champlin and J. Gajewski",
year = "1994",
month = "1",
day = "1",
language = "English",
volume = "88",
pages = "72--78",
journal = "British Journal of Haematology",
issn = "0007-1048",
publisher = "Wiley-Blackwell",
number = "1",

}

TY - JOUR

T1 - Treatment of advanced acute leukaemia with allogeneic bone marrow transplantation from unrelated donors

AU - Schiller, G.

AU - Feig, S. A.

AU - Territo, M.

AU - Wolin, M.

AU - Lill, M.

AU - Belin, T.

AU - Hunt, L.

AU - Nimer, Stephen D

AU - Champlin, R.

AU - Gajewski, J.

PY - 1994/1/1

Y1 - 1994/1/1

N2 - Bone marrow transplantation from a histocompatible sibling donor may produce complete remission in patients with induction failure or relapsed acute leukaemia. Through the National Marrow Donor Program, histocompatible bone marrow from unrelated donors has become available for high-risk patients. In this study we analyse the results of matched unrelated bone marrow transplant in 55 patients with highly advanced acute myelogenous and acute lymphoblastic leukaemia. 28 patients with advanced acute lymphoblastic leukaemia and 27 patients with advanced acute myelogenous leukaemia, age 2-51, were treated with high-dose chemoradiotherapy and transplantation of 6/6 HLA matched (n = 46) or one antigen mismatched (n = 9) unrelated donor bone marrow. After a median follow-up of 36 months, 13 patients remain alive 17-74 months after transplant for a 2-year actuarial disease-free and overall survival of 23 ± 12% (median disease-free survival 3.5 months). The actuarial risk of relapse is 24 ± 16% at 1 year. Moderate to severe graft-versus-host disease occurred in 27/47 evaluable patients (57%). Significant prognostic factors for poor leukaemia-free survival include age >21, abnormal karyotype, and active leukaemia at the time of transplant. Other pretreatment characteristics such as gender or type of leukaemia were not significant prognostic factors. Our results show that matched unrelated bone marrow transplant for patients with advanced acute leukaemia may provide long-term leukaemia-free survival, but transplant-related complications produce a significant impact on survival with older age and adverse disease characteristics predicting for poor prognosis.

AB - Bone marrow transplantation from a histocompatible sibling donor may produce complete remission in patients with induction failure or relapsed acute leukaemia. Through the National Marrow Donor Program, histocompatible bone marrow from unrelated donors has become available for high-risk patients. In this study we analyse the results of matched unrelated bone marrow transplant in 55 patients with highly advanced acute myelogenous and acute lymphoblastic leukaemia. 28 patients with advanced acute lymphoblastic leukaemia and 27 patients with advanced acute myelogenous leukaemia, age 2-51, were treated with high-dose chemoradiotherapy and transplantation of 6/6 HLA matched (n = 46) or one antigen mismatched (n = 9) unrelated donor bone marrow. After a median follow-up of 36 months, 13 patients remain alive 17-74 months after transplant for a 2-year actuarial disease-free and overall survival of 23 ± 12% (median disease-free survival 3.5 months). The actuarial risk of relapse is 24 ± 16% at 1 year. Moderate to severe graft-versus-host disease occurred in 27/47 evaluable patients (57%). Significant prognostic factors for poor leukaemia-free survival include age >21, abnormal karyotype, and active leukaemia at the time of transplant. Other pretreatment characteristics such as gender or type of leukaemia were not significant prognostic factors. Our results show that matched unrelated bone marrow transplant for patients with advanced acute leukaemia may provide long-term leukaemia-free survival, but transplant-related complications produce a significant impact on survival with older age and adverse disease characteristics predicting for poor prognosis.

KW - Acute leukaemia

KW - Allogeneic BMT

KW - Relapsing

KW - Resistant

KW - Unrelated donor

UR - http://www.scopus.com/inward/record.url?scp=0027934753&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0027934753&partnerID=8YFLogxK

M3 - Article

C2 - 7803259

AN - SCOPUS:0027934753

VL - 88

SP - 72

EP - 78

JO - British Journal of Haematology

JF - British Journal of Haematology

SN - 0007-1048

IS - 1

ER -