Bone marrow transplantation for primary refractory acute leukaemia

Area of Science:

• Hematology
• Oncology
• Transplantation Immunology

Background:

• Primary resistant acute leukaemia presents a significant therapeutic challenge.
• Conventional chemotherapy often fails to induce complete remission in these patients.

Purpose of the Study:

• To evaluate the efficacy and outcomes of bone marrow transplantation (BMT) in patients with primary resistant acute leukaemia.
• To assess the rates of complete remission, survival, and transplant-related complications following BMT.

Main Methods:

• Retrospective analysis of 24 patients with primary resistant acute leukaemia undergoing BMT.
• Utilized various donor types: matched sibling, syngeneic, matched unrelated, and mismatched family donors.
• Monitored for complete remission (CR), graft failure, cytomegalovirus pneumonitis, relapses, and overall survival.

Main Results:

• Complete remission (CR) was achieved in 85% (17 of 20) of evaluable patients post-BMT.
• 12.5% of patients achieved long-term survival (2-10 years).
• Significant transplant-related mortality occurred, including early deaths (16.7%), cytomegalovirus pneumonitis (2 patients), and graft failure (1 patient).
• Among patients achieving CR, 58.8% died from transplant-related complications, and 23.5% relapsed.

Conclusions:

• BMT can induce CR in a high proportion of acute leukaemia patients refractory to chemotherapy.
• Despite high CR rates, BMT is associated with substantial transplant-related complications and relapses, impacting long-term survival.
• A small subset of patients can achieve long-term survival following BMT for resistant acute leukaemia.