Allogeneic Bone Marrow Transplantation for Acute Myelogenous Leukemia: Retrospective Analysis in a Single Institution.
- Author:
Inho KIM
1
;
Joo Young JUNG
;
Soo Mee BANG
;
Jae Ho BYUN
;
Heung Moon CHANG
;
Moon Hee LEE
;
Young Jin YOO
;
Jin Seok AHN
;
Jong Tae LEE
;
Seok Ah IM
;
Chul Won JUNG
;
Sung Hyun YANG
;
Myung Don OH
;
Kang Won CHOE
;
Kyou Sup HAN
;
Myoung Hee PARK
;
Sung Whan HA
;
Charn Il PARK
;
Kyung Hae JUNG
;
Seonyang PARK
;
Byoung Kook KIM
Author Information
1. Department of Internal Medicine, Seoul National University Hospital, College of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Bone marrow transplantation;
AML
- MeSH:
Adult;
Bone Marrow Transplantation*;
Bone Marrow*;
Cause of Death;
Cyclosporine;
Disease-Free Survival;
Etoposide;
Female;
Follow-Up Studies;
Graft vs Host Disease;
Humans;
Incidence;
Leukemia;
Leukemia, Myeloid, Acute*;
Lung Diseases, Interstitial;
Male;
Medical Records;
Methotrexate;
Neutrophils;
Recurrence;
Retrospective Studies*;
Sepsis;
Siblings;
Tissue Donors
- From:Korean Journal of Hematology
1999;34(4):573-583
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Acute myelogenous leukemia (AML) is the most common cause of leukemia in adults. Allogeneic bone marrow transplantation (BMT) for the treatment of AML is done worldwide now. METHODS: Between November 1987 and June 1998, we performed allogeneic BMT for 27 patients with AML from HLA-identical sibling donors. We reviewed medical records of these patients. RESULTS: The median age of patients was 31 (range, 15~43) and male to female ratio was 18 : 9. Conditioning regimens were BU/CY (busulfan, cyclophosphamide) for 22 patients, TBI/CY (total body irradiation, cyclophosphamide) for 3 patients, and TBI/VP/CY (TBI, VP-16, cyclophosphamide) for 2 patients. Cyclosporine and methotrexate were used in 18 patients for prophylaxis of graft-versus-host disease (GVHD), and cyclosporine and methyl-prednisolone were used in 9 patients. The median nucleated cell dose given to patients was 4.1x108 /kg. All evaluable patients achieved absolute neutrophil count of 500 /microliter after median 15 days after BMT (range, 11~45 days). Twenty-five percent of patients developed acute GVHD (> or = grade II) and there was no patient with grade IV acute GVHD. Twenty-nine percent developed chronic GVHD. Hepatic venoocclusive disease (VOD) occurred in 7 patients (26%). At the time of BMT, 16 patients were in the first remission status and 11 patients were in the advanced disease status. After a median follow-up of 27 months (range 7~127 months), the actuarial disease-free survival at 5 years was significantly higher in the first remission group than the others (44% vs. 9%; P=0.05). The difference of 5 year overall survival between these two groups approached statistical significance (50%for the first remission group and 12% for the others; P=0.13). There were 17 deaths. The causes of death were relapse (8 patients, 47%), VOD (3 patients, 18%), sepsis (2 patients, 12%), interstitial pneumonia (2 patients, 12%), chronic GVHD (1 patient, 6%), and drug-toxicity (1 patient, 6%). Eary deaths (<100 days) occurred in 6 patients (22%). CONCLUSION: Allogeneic BMT for patients with AML was most successful when done during the first remission. Clinical features of patients with AML treated with allogeneic BMT were similar to those from Western countries, but the incidence and severity of acute GVHD seem to be lower.
