A SINGLE-CENTER STUDY EVALUATING ACCESSIB ILITY TO BONE-MARROW TRANSPLANTATION IN 52 PATIENTS WITH ACUTE MYELOID-LEUKEMIA

BACKGROUND: A single-center experience review about accesibility to bo ne marrow transplantation (BMT) as postremission therapy for acute mye loid leukemia (AML) is analyzed, PATIENTS AND METHODS: From January 19 88 to December 1994, 86 patients were diagnosed from de novo AML in ou r Institution, A BMT was the treatment of choice for all patients youn ger than 55 years. An allogeneic BMT (Allo-BMT) was offered for all pa tients younger than 35 years with a compatible sibling donor or these older patients, 35-55 years, with bad prognosis features. An autologus BMT (ABMT) was offered to those patients older than 35 years or those younger than 35 without an histocompatible donor, RESULTS: 52 out of 86 diagnosed patients were younger than 50 years (60%), 29 of them wer e candidates to Allo-BMT (24 patients younger than 35 years and 5 pati ents older than 35 with refractory disease) and the rest 23 to ABMT, 2 2 out of the 24 candidates to Allo-BMT entered complete remission (CR) and 12 of them had an HLA-identical donor. The Allo-BMT was performed in CR1 in 7 patients in CR2 in three patients and with refractory dis ease in two cases. An ABMT was finally planned in 30 patients, 18 pati ents older than 35 who entered CR and the rest 12 patients younger tha n 35 years in CR without a sibling donor. Only 11 out of this 30 patie nts underwent an ABMT in first CR, Reasons for this low number were: e arly relapse (8), toxicity (6), refuse (2), lost of follow-up (2) and suicide (1), Five out of this early relapse patients underwent an ABMT in CR2. Disease-free survival (DFS) at three years was 23 +/- 10% for the 52 patients included in the study. DFS obtained with Allo-BMT and AMBT were 39 +/- 16% and 63 +/- 22% respectively. CONCLUSIONS: In spi te of the new postremission treatment modalities available for AML the rate of longer survivals are still low. When data from BMT is analyze d we must be awared because only a small fraction of patients assigned to BMT will finally access to this treatment.