1. Bone marrow transplantation for adults with acute leukaemia and 11q23 chromosomal abnormalities
- Author
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D L, Forrest, T J, Nevill, D E, Horsman, D A, Brockington, H C, Fung, C L, Toze, E A, Conneally, D E, Hogge, H J, Sutherland, S H, Nantel, J D, Shepherd, and M J, Barnett
- Subjects
Adult ,Chromosome Aberrations ,Male ,Leukemia ,Adolescent ,Chromosomes, Human, Pair 11 ,Middle Aged ,Combined Modality Therapy ,Disease-Free Survival ,Treatment Outcome ,Acute Disease ,Antineoplastic Combined Chemotherapy Protocols ,Humans ,Transplantation, Homologous ,Female ,Aged ,Bone Marrow Transplantation ,Retrospective Studies - Abstract
Adults with acute leukaemia and abnormalities of chromosome 11q23 have a poor prognosis when treated with conventional chemotherapy. To determine whether more intensive therapy can improve outcome for patients with this karyotypic finding, a retrospective analysis of all patients with acute leukaemia and 11q23 abnormalities treated at our centre was performed. 12 patients were treated with conventional chemotherapy alone (CC); 20 patients received high-dose chemo/radiotherapy (HDCT) with autologous (seven patients) or allogeneic (13 patients) bone marrow transplantation (BMT). The treatment-related mortality was 25% [95% Confidence Interval (CI) 7-69%] for the CC group and 46% (CI 25-73%) for the BMT group (P = 0.69). Cumulative risk of leukaemia progression was 89% (CI 61-100%) in the CC patients and 38% (CI 12-69%) in the BMT patients (P = 0.001). The 2-year event-free survival for patients treated with CC was 8% (CI 0-31%) and for patients receiving HDCT and BMT was 34% (CI 14-54%) (P = 0.03). These results confirm that conventional chemotherapy is rarely curative for adults with acute leukaemia and 11q23 abnormalities but that HDCT with BMT can result in long-term survival in a significant proportion of patients.
- Published
- 1998