Lc. Dunlop et al., BONE-MARROW TRANSPLANTATION FOR PHILADELPHIA-CHROMOSOME-POSITIVE ACUTE LYMPHOBLASTIC-LEUKEMIA, Bone marrow transplantation, 17(3), 1996, pp. 365-369
Between 1986 and 1995, 19 patients with Philadelphia chromosome-positi
ve (Ph+) acute lymphoblastic leukemia underwent 20 autologous (n = 9)
or allogeneic (n = 11) blood or marrow transplant procedures in first
(n = 12) or second (n = 3) remission, or in relapse (n = 5). Four pati
ents died due to transplant-related causes, 11 relapsed at 3-39 months
, one survives with disease which did not remit after transplant, and
three are alive in continuous remission at 1, 26 and 65 months. Two of
the relapsing patients are alive; one autografted patient after an al
lograft in second remission and one allografted patient after a donor
leukocyte infusion. The projected overall survival is 37.5% at 3 years
and 12.5% at 5 years. The 3-year probabilities of relapse and disease
-free survival for autografted patients are 65.9% and 25.6% respective
ly, and for allografted patients, 63.4% and 21.8% respectively. The st
age of the disease at the time of transplant or the type of transplant
did not affect the outcome significantly, and late relapses beyond 3
years were seen after allogeneic as well as autologous transplantation
. In our experience, the outcome of patients with Ph+ acute lymphoblas
tic leukemia continues to be poor despite high-dose therapy due to hig
h relapse rates, and the development of additional measures to enhance
the antileukemic efficacy of bone marrow transplantation is necessary
.