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Comparison of autologous and allogeneic bone marrow transplantation in children with acute leukemia.

Abstract
Thirty-one patients with acute non-lymphocytic leukemia (18 patients) or with high-risk refractory acute lymphocytic leukemia (13 patients) underwent bone marrow transplantation between March 1980 and March 1990. The high-dose conditioning regimen employed included cyclophosphamide followed by fractionated total body irradiation (12 GY). Fourteen patients who had an HLA-identical sibling donor received allogeneic bone marrow transplantation (allo-BMT); the other 17 patients received autologous bone marrow transplantation (auto-BMT) purged with 4-hydroperoxycyclophosphamide (4HC). Four of the 14 allo-graft recipients died of leukemic relapse and 2 others died of graft-versus-host disease. Three of the 17 auto-graft recipients died of relapse and 1 suffered relapse in the testes. The actuarial risk of relapse was 29% for the allo-BMT patients and 24% for the auto-BMT patients (P less than 0.05). The event-free survival rate at five years was 57% and 74% respectively (P less than 0.05). Although there was no difference between them, a trend toward a higher survival rate and a lower mortality and morbidity was observed in the auto-BMT group. These results suggest that autologous bone marrow transplantation purged with 4HC is an effective and useful treatment for children with acute non-lymphocytic and lymphocytic leukemia who have no HLA-identical donor.
AuthorsM Ohira, J Takayama
JournalActa paediatrica Japonica : Overseas edition (Acta Paediatr Jpn) Vol. 33 Issue 4 Pg. 558-63 (Aug 1991) ISSN: 0374-5600 [Print] Australia
PMID1792916 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
Topics
  • Adolescent
  • Bone Marrow Transplantation (methods)
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Leukemia, Myeloid, Acute (therapy)
  • Male
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma (mortality, therapy)
  • Recurrence
  • Survival Rate
  • Transplantation, Autologous
  • Transplantation, Homologous
  • Treatment Outcome

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