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Allografting

Allogeneic stem-cell transplantation in patients with refractory acute leukemia: a long-term follow-up

Bone Marrow Transplantation volume 37, pages 45–50 (2006)Cite this article

Abstract

We examined retrospectively 44 patients with refractory acute leukemia (acute myeloid leukemia (AML)/acute lymphoblastic leukemia=25/19) who underwent allogeneic transplantation at our center between 11/1990 and 04/2004. The median leukemic blasts was 25% and age 28 years (range, 3–56). Twenty-one patients had untreated relapse, 13 failed reinduction, eight in partial remission and two aplastic. Conditioning was myeloablative using cyclophosphamide, busulfan, total-body irradiation and etoposide (Bu/Cy/VP, n=22; TBI/Cy/VP, n=17; others, n=5) followed by marrow or peripheral blood transplant (n=23/21) from unrelated or related donors (n=28/16). All patients had graft-versus-host disease (GVHD) prophylaxis with cyclosporin and methotrexate. One patient experienced late graft failure. Severe acute-GVHD and chronic-GVHD appeared in eight and 14 patients, respectively. Thirteen patients (30%) remain alive after a median of 25.3 months (range, 2.4–134.1); with 31 deaths, mostly from relapse (n=15) and infections (n=12). Overall survival (OS) and progression-free survival (PFS) at 5 years was 28 and 26%, respectively. OS and PFS were significantly better with blasts ⩽20% and time to transplant ⩽1 year while transplant-related mortality was less with the use of TBI. We conclude that patients with refractory leukemia can benefit from allogeneic BMT, especially with ⩽20% marrow blast.

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Acknowledgements

We are grateful for the dedicated care of the patients involved in this study by the other members of our team, nurses, physiotherapist, clinical psychologist, data managers, study transplant coordinators and the technicians of our transplant facility at the KMT Station und Labore, Universitätsklinikum Hamburg-Eppendorf.

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Authors and Affiliations

  1. Department of Bone Marrow Transplantation, University-Hospital Hamburg-Eppendorf, Hamburg, Germany

    A A Oyekunle, N Kröger, T Zabelina, F Ayuk, H Schieder, H Renges, N Fehse, O Waschke, B Fehse, H Kabisch & A R Zander

  2. Department of Haematology and Blood Transfusion, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria

    A A Oyekunle

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  1. A A Oyekunle
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  2. N Kröger
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Correspondence to A A Oyekunle.

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Oyekunle, A., Kröger, N., Zabelina, T. et al. Allogeneic stem-cell transplantation in patients with refractory acute leukemia: a long-term follow-up. Bone Marrow Transplant 37, 45–50 (2006). https://doi.org/10.1038/sj.bmt.1705207

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