Mayo Clinic Experience With Allogeneic and Syngeneic Bone Marrow Transplantation, 1982 Through 1990

Between April 1982 and July 1990, 101 patients underwent allogeneic or syngeneic bone marrow transplantation at the Mayo Clinic. This patient population consisted of 30 with acute nonlymphocytic leukemia, 25 with acute lymphoblastic leukemia, 29 with chronic granulocytic leukemia, and 17 with other...

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Published in:Mayo Clinic proceedings 1992-02, Vol.67 (2), p.109-116
Main Authors: LETENDRE, LOUIS, HOAGLAND, H. CLARK, MOORE, S. BREANNDAN, CHEN, MICHAEL G., GASTINEAU, DENNIS A., GERTZ, MORIE A., HABERMANN, THOMAS M., LITZOW, MARK R., NOËL, PIERRE, SOLBERG, LAWRENCE A., TEFFERI, AYALEW
Format: Article
Language:English
Subjects:
Academic Medical Centers
Adolescent
Adult
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Bone Marrow Transplantation - adverse effects
Bone Marrow Transplantation - standards
Bone Marrow Transplantation - trends
Bone marrow, stem cells transplantation. Graft versus host reaction
Child
Child, Preschool
Clinical Protocols - standards
Cytomegalovirus Infections - epidemiology
Cytomegalovirus Infections - etiology
Female
Follow-Up Studies
General & Internal Medicine
Graft vs Host Disease - drug therapy
Graft vs Host Disease - epidemiology
Graft vs Host Disease - etiology
Humans
Incidence
Leukemia - therapy
Life Sciences & Biomedicine
Male
Medical sciences
Medicine, General & Internal
Minnesota - epidemiology
Prognosis
Recurrence
Remission Induction - methods
Science & Technology
Survival Rate
Transfusions. Complications. Transfusion reactions. Cell and gene therapy
Transplantation, Homologous - adverse effects
Transplantation, Homologous - standards
Transplantation, Homologous - trends
Transplantation, Isogeneic - adverse effects
Transplantation, Isogeneic - standards
Transplantation, Isogeneic - trends
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Summary:Between April 1982 and July 1990, 101 patients underwent allogeneic or syngeneic bone marrow transplantation at the Mayo Clinic. This patient population consisted of 30 with acute nonlymphocytic leukemia, 25 with acute lymphoblastic leukemia, 29 with chronic granulocytic leukemia, and 17 with other diseases (aplastic anemia in 7, myelodysplastic syndrome in 5, and lymphoma in 5). The results achieved in our patients who underwent transplantation in first complete remission of both acute nonlymphocytic leukemia and acute lymphoblastic leukemia compare favorably with previously reported results. Only 1 of 15 patients (7%) with acute nonlymphocytic leukemia and 2 of 8 patients (25%) with acute lymphoblastic leukemia who underwent transplantation in first complete remission had a relapse. Thus, we recommend early bone marrow transplantation during initial complete remission for patients with either of these disorders who have adverse prognostic factors. In contrast, of 12 patients with either acute nonlymphocytic leukemia or acute lymphoblastic leukemia who underwent transplantation during relapse, 11 died within 6 months. Therefore, such patients should be offered new experimental treatments. Our patients with chronic granulocytic leukemia fared better when they underwent transplantation early during the course of their disease rather than during the accelerated or blast phase. Prospective studies are needed to determine the best approach in these patients.
ISSN:0025-6196
1942-5546
DOI:10.1016/S0025-6196(12)61309-3