BONE-MARROW TRANSPLANTATION FOR PRIMARY REFRACTORY ACUTE-LEUKEMIA

Twenty-four patients with primary resistant acute leukaemia received b one marrow transplants (BMTs) from matched sibling, syngeneic, matched unrelated, or mismatched family donors as treatment for induction fai lure. Three (12.5%) patients are alive and well 2-10 years after trans plantation. Four (16.7%) patients died of transplant-related complicat ions early post-transplant and remission status could not be determine d. Two patients did not achieve complete remission (CR) and died of cy tomegalovirus pneumonitis 3 months post-transplant. One patient died o f graft failure. CR was obtained in 17 of 20 (85%) evaluable patients after BMT. Ten of 17 (58.8%) patients achieving CR died of transplant- related complications 1-10 months posttransplant. Four of 17 (23.5%) p atients who had achieved CR relapsed after transplant. We conclude tha t a high proportion of patients failing to achieve remission with aggr essive conventional chemotherapy achieve CR with BMT and a small propo rtion become long-term survivors.