Bone marrow transplantation for primary refractory acute leukaemia

Twenty-four patients with primary resistant acute leukaemia received bone marrow transplants (BMTs) from matched sibling, syngeneic, matched unrelated, or mismatched family donors as treatment for induction failure. Three (12.5%) patients are alive and well 2-10 years after transplantation. Four (16.7%) patients died of transplant-related complications early post-transplant and remission status could not be determined. Two patients did not achieve complete remission (CR) and died of cytomegalovirus pneumonitis 3 months post-transplant. One patient died of graft failure. CR was obtained in 17 of 20 (85%) evaluable patients after BMT. Ten of 17 (58.8%) patients achieving CR died of transplant-related complications 1-10 months post-transplant. Four of 17 (23.5%) patients who had achieved CR relapsed after transplant. We conclude that a high proportion of patients failing to achieve remission with aggressive conventional chemotherapy achieve CR with BMT and a small proportion become long-term survivors.