AUTOLOGOUS BONE-MARROW TRANSPLANTATION FOR CHILDHOOD ACUTE LYMPHOBLASTIC-LEUKEMIA IN REMISSION - FIRST CHOICE FOR ISOLATED EXTRAMEDULLARY RELAPSE

Between May 1984 and May 1992, 75 children 3-19 (median 9) years of ag e underwent autologous marrow transplant, Clinical data were obtained from the BMT Registry of the AIEOP (Italian Association of Pediatric H emato/Oncology). Fifty-six children were transplanted after marrow +/- other site(s) relapse and 19 after an isolated extramedullary relapse . The transplant preparative regimens varied according to the center p erforming the transplant, Seven patients (9%) died of transplant-relat ed complications, Forty-four (58.6%) of 75 patients relapsed again fol lowing autologous BMT. The 5-year DFS was 27.8%, An isolated extramedu llary relapse was the only variable that statistically influenced DFS. In this retrospective study, autologous BMT for patients with ALL in second CR following marrow relapse did not offer an encouraging result (13% probability of DFS at 5 years), whereas autologous BMT following an (early) isolated extramedullary relapse resulted in nearly 70% DFS . Autologous BMT may be appropriate for this latter group of patients.