Bone-marrow transplantation for acute leukaemia in first remission. 1982

R P Gale, and H E Kay, and A A Rimm, and M M Bortin

Between 1978 and 1980 133 patients with acute myelogenous leukaemia were given allogeneic bone-marrow transplants from an HLA-identical sibling and were followed up for at least a year. Pre-transplant preparation consisted of high-dose chemotherapy and/or radiation and post-transplant immune suppression consisted of methotrexate or cyclosporin-A. Data for 76 patients transplanted in first transplanted in either second to fourth remission, partial remission, or relapse. The 2-year actuarial survival-rate was 48% (95% CI, 36-60%) for patients transplanted in first remission and 30% 95% CI, 17-43%) for patients with more advanced disease (p = 0.037). Disease status at the time of transplantation was related to the probability of survival (p less than 0.02). The 2-year actuarial leukaemia recurrence-rate was 32% for patients transplanted in first remission and 50% for patients with more advanced disease (p = 0.0017). The probability of remaining in remission also was associated with disease status at time of transplantation (p less than 0.01). The incidence of graft-vs-host disease and interstitial pneumonitis was similar for patients transplanted in first remission and those transplanted later, and methotrexate and cyclosporin A were equally effective in modifying acute GVHD. These data indicate that prolonged survival can be achieved in approximately one-half of patients with acute myelogenous leukaemia given transplants of bone marrow from an HLA-identical sibling during their first complete remission.

UI MeSH Term Description Entries
D007166 Immunosuppressive Agents Agents that suppress immune function by one of several mechanisms of action. Classical cytotoxic immunosuppressants act by inhibiting DNA synthesis. Others may act through activation of T-CELLS or by inhibiting the activation of HELPER CELLS. While immunosuppression has been brought about in the past primarily to prevent rejection of transplanted organs, new applications involving mediation of the effects of INTERLEUKINS and other CYTOKINES are emerging. Immunosuppressant,Immunosuppressive Agent,Immunosuppressants,Agent, Immunosuppressive,Agents, Immunosuppressive
D007223 Infant A child between 1 and 23 months of age. Infants
D007959 Lymphocyte Culture Test, Mixed Measure of histocompatibility at the HL-A locus. Peripheral blood lymphocytes from two individuals are mixed together in tissue culture for several days. Lymphocytes from incompatible individuals will stimulate each other to proliferate significantly (measured by tritiated thymidine uptake) whereas those from compatible individuals will not. In the one-way MLC test, the lymphocytes from one of the individuals are inactivated (usually by treatment with MITOMYCIN or radiation) thereby allowing only the untreated remaining population of cells to proliferate in response to foreign histocompatibility antigens. Leukocyte Culture Test, Mixed,Mixed Lymphocyte Culture Test,Mixed Lymphocyte Reaction,Mixed Leukocyte Culture Test,Mixed Leukocyte Reaction,Leukocyte Reaction, Mixed,Leukocyte Reactions, Mixed,Lymphocyte Reaction, Mixed,Lymphocyte Reactions, Mixed,Mixed Leukocyte Reactions,Mixed Lymphocyte Reactions
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011182 Postoperative Care The period of care beginning when the patient is removed from surgery and aimed at meeting the patient's psychological and physical needs directly after surgery. (From Dictionary of Health Services Management, 2d ed) Care, Postoperative,Postoperative Procedures,Procedures, Postoperative,Postoperative Procedure,Procedure, Postoperative
D011300 Preoperative Care Care given during the period prior to undergoing surgery when psychological and physical preparations are made according to the special needs of the individual patient. This period spans the time between admission to the hospital to the time the surgery begins. (From Dictionary of Health Services Management, 2d ed) Care, Preoperative,Preoperative Procedure,Preoperative Procedures,Procedure, Preoperative,Procedures, Preoperative
D011658 Pulmonary Fibrosis A process in which normal lung tissues are progressively replaced by FIBROBLASTS and COLLAGEN causing an irreversible loss of the ability to transfer oxygen into the bloodstream via PULMONARY ALVEOLI. Patients show progressive DYSPNEA finally resulting in death. Alveolitis, Fibrosing,Idiopathic Diffuse Interstitial Pulmonary Fibrosis,Fibroses, Pulmonary,Fibrosis, Pulmonary,Pulmonary Fibroses,Alveolitides, Fibrosing,Fibrosing Alveolitides,Fibrosing Alveolitis
D012008 Recurrence The return of a sign, symptom, or disease after a remission. Recrudescence,Relapse,Recrudescences,Recurrences,Relapses
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children

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