1. Mayo Clinic experience with allogeneic and syngeneic bone marrow transplantation, 1982 through 1990.
- Author
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Letendre L, Hoagland HC, Moore SB, Chen MG, Gastineau DA, Gertz MA, Habermann TM, Litzow MR, Noël P, and Solberg LA Jr
- Subjects
- Academic Medical Centers, Adolescent, Adult, Bone Marrow Transplantation adverse effects, Bone Marrow Transplantation trends, Child, Child, Preschool, Clinical Protocols standards, Cytomegalovirus Infections epidemiology, Cytomegalovirus Infections etiology, Female, Follow-Up Studies, Graft vs Host Disease drug therapy, Graft vs Host Disease epidemiology, Graft vs Host Disease etiology, Humans, Incidence, Male, Minnesota epidemiology, Prognosis, Recurrence, Remission Induction methods, Survival Rate, Transplantation, Homologous adverse effects, Transplantation, Homologous trends, Transplantation, Isogeneic adverse effects, Transplantation, Isogeneic trends, Bone Marrow Transplantation standards, Leukemia therapy, Transplantation, Homologous standards, Transplantation, Isogeneic standards
- Abstract
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.
- Published
- 1992
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