2009•Acta HaematologicaRequires access
Bone Marrow Transplantation (BMT) for Acute Nonlymphoid Leukemia (ANLL) in First Remission
Andrea Paolo Bacigalupo, Francesco Frassoni, Maria Teresa Van Lint, P.A. Pittaluga, Giovanna Piaggio, Maria Pía Repetto, Matteo Congiu, V. Vitale, Daniele Scarpati, Renzo Corvò, Giorgio Ricci, Giovanni Adami, Rebecca Adami, Giuseppe Lercari, Domenico Occhini, A. M. Marmont
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Abstract
20 patients with acute nonlymphoid leukemia (ANLL) in first remission were given cyclophosphamide, 120 mg/kg, followed by total body irradiation (TBI) and an HLA-identical allogeneic marrow transplant (BMT). TBI was delivered in a single dose (10 Gy on day -1) in 2 patients, or in fractionated doses (3.3 rad/day on days -3, -2, -1) in 18 patients. The median age of patients was 22 years (range 2-44). Median time from remission to BMT was 5 months (range 1-12). 5 patients died of transplant-related toxicity (graft-versus-host disease with or without interstitial pneumonia) and 15 are alive 7-77 months post-BMT (median 20). The actuarial 72 months survival is 73%. There has been one relapse in a 2-year-old child, 4 months post-BMT, in the marrow and in the testis. The 72-month actuarial disease-free survival is 68%. The actuarial probability of relapse is 7%. This study indicates that a high proportion of ANLL patients treated in first remission with fractionated TBI and allogeneic marrow transplantation can become long-term disease-free survivors.