ALLOGENEIC BONE-MARROW TRANSPLANTATION REMAINS AN EFFICIENT CONSOLIDATION FOR ADULTS WITH ACUTE MYELOID-LEUKEMIA EVEN WHEN PERFORMED VERY SOON AFTER DIAGNOSIS (LESS-THAN-100 DAYS)

Allogeneic BMT is presently recognized as one of the reference anti-le ukemic treatments for AML patients. It could be a very useful therapy in CR1 AML if it is efficient as an early form of consolidation after Induction therapy. Later procedures may be of lesser Importance since they concern a population which may have already been cured by chemoth erapy. Alternatively it is not solved ii very early BMT gives patients sufficient therapy and provides lower toxicity. To answer this questi on we analyzed data from the Societe Francaise de Greffe de Moelle (SF GM) on a sub-group of patients according to the following criteria: (1 ) Allogeneic BMT carried out on patients with AML in CR1; (2) after Ja nuary 1985; (3) conditioning with CyTBl; (4) GVHD prophylaxis with MTX -CsA; (5) interval between diagnosis and BMT < 100 days. Forty-two ful filled all criteria, Age was 31 +/- 8 years and M/F ratio was 19/23. W BC at diagnosis were 36 +/- 49 x 10(9)/l and four patients needed two induction courses to achieve CR1. Median follow-up is now 51 (24-116) months. Twenty-two patients developed a grade greater than or equal to 2 acute GVHD. Early transplant mortality at 1 year is no higher than 14%. Two patients died of secondary malignancies at 3,5 and 6.5 years after BMT. Finally 5-year (and 7-year) probabilities for relapse, surv ival, leukemia and event-free survival are respectively 17% (17%), 71% (62%), and 71% (71%) and 68% (59%). These data indicate the feasibili ty of such an approach with low mortality and low relapse rates provid ing a good long-term outcome. This should prompt an invitation to init iate the search for an HLA-identical sibling when AML is diagnosed in a young patient eligible for allo-BMT.