Nr. 3 - 3. Quartal 1994

Allogenic Bone Marrow Transplantation Versus Chemotherapy for Patients with Acute Myelogenous Leukaemia in First Remission

B. Labar, M. Mrsic, D. Nemet, V. Bogdanic, I. Radman, D. Boban, D. Batinic, S. Kalenic, M. Vrtar, Lj. Grgic-Markulin, A. Kastelan, M. Marusic

From January 1984 122 patients with de-novo AML who achieved first complete remission were included into a prospective study comparing allogeneic BMT with chemotherapy. Thirty one patients had eligible HLA identical marrow donor and were grafted using standard conditioning regimen consisted of total body irradiation or busulfan followed by cyclophosphamide. Other patients were maintained on the two standard chemotherapy protocols consisted of less intensive early and late consolidation followed by maintenance therapy (AML-83) or two very intensive consolidation cycles (AML-88). Four year probability of leukaemia-free survival for patients receiving marrow graft was 68+/-14% while for patients on the chemotherapy were 28+/-24% (AML-88) and 21+/-18% (AML-83) (p < .01). The probability of leukaemia relapse was significantly higher in the chemotherapy groups than in transplant group (84+/-14% for AML-83 and 61+/-38% for AML-88 vs 20+/-15% for BMT P < .01). There was no statistical difference in the outcome regarding two different postremission chemotherapy protocols.

Sixty five patients (71%)in the chemotherapy groups and 3 (10%) in the BMT cohort relapsed. The main cause of death for BMT group was GVHD with or without infections (5 (16%) patients). Twenty-three patients (74%) in the transplant group and 23 (25%) patients in the chemotherapy cohort were alive with a median of follow-up of 54 (range 12-108) and 32 (range 6-98) months respectively.

Keywords:

Leukaemia, bone marrow transplantation, chemotherapy

Kurztitel:

Labar, B. et al. (1994) TxMed 3:235

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