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Bone marrow transplantation for acute lymphoblastic leukaemia: a survey of the European Group for Bone Marrow Transplantation (E.G.B.M.T.)

Between 1979 and 1982, 192 patients with acute lymphoblastic leukaemia were given allogenic bone marrow transplants from HLA‐identical siblings. Data on 5 7 patients transplanted in first remission were compared with the results in 96 patients transplanted in second remission, and 39 in third or subsequent remission. The majority of these patients were of the non‐B non‐T‐ALL and T‐ALL subtypes. The 2‐year actuarial survival for non‐B non‐T‐ALL was 58% for patients transplanted in first remission, 34% for second remission patients and 33% for patients transplanted in third or subsequent remission (P= O60). For patients with T‐ALL, the survivals at 2 years for first and second remission transplant patients were 61% and 10%, respectively (P=0‐04). Multifactorial analysis demonstrated a significantly higher probability of survival for patients grafted in first remission (compared with more advanced remission states) and with bone marrow from young (age ≤ 20 years) donors. The 2‐year actuarial risk of relapse for patients with non‐B non‐T‐ALL transplanted in first remission was 0%, 32% and 69% for second and third or subsequent remission patients, respectively (P= 0‐04). For T‐ALL the actuarial risk of relapse at 2 years is 10% for first remission grafts and 48% for second remission grafts (P= 0‐07). Only patients (with both non‐B non‐T‐/and T‐ALL) transplanted in first remission have a high and stable probability of remaining in remission.