Bone Marrow Transplantation from Histocompatible Sibling Donors for Patients with Acute Lymphoblastic Leukemia

Between March 1977 and September 1988, 150 patients with acute lymphoblastic leukemia (ALL) were treated with myeloablative radiochemotherapy followed by allogeneic bone marrow transplantation (BMT). Prophylaxis to prevent graft-versus-host disease consisted of methotrexate (MTX)/prednisone (PSE), cyclosporine A (CSA)/PSE, or CSA/PSE/MTX. Fifty patients were in first complete remission (CR) at the time when preparation for BMT was begun (median age, 25 years; range, 1 infant was 1.8 years and 49 adults aged 16–41 years); 49 patients were either in second or third CR (19 years; 3–48 years) and 51 patients were in relapse (22 years; 5–45 years). Median follow-up for these patients is now in excess of 4 years. Actuarial disease-free survival (DFS) rates for the three groups of BMT recipients are 61%, 45%, and 19%. Actuarial relapse rates are 14%, 41%, and 64%, respectively. These data are summarized in Table 1.