Long-term outcome of adult acute leukemia patients who are alive and well 2 years after autologous blood or marrow transplantation

S. Singhal*, R. Powles, J. Treleaven, S. Kulkarni, C. Horton, J. Mehta

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

We studied the long-term outcome of 87 adults with acute leukemia (age 15-59 years at transplant, median 27; 44 myeloid, 42 lymphoblastic, one biphenotypic) who were alive in continuous remission 2 years after a marrow (n = 74) or blood stem cell (n = 13) autograft. Nine relapsed 25-50 months (median 38) after transplantation. Five relapses were straightforward with no karyotypic or morphologic evolution of the original disease. Four recurrences were unusual, with development of myelodysplasia (n = 3) or myeloproliferative disease (n = 1). Five patients died of relapsed disease and four are still alive. Two patients died of complications related to the transplant, and one of ischemic heart disease. Seventy-nine patients (91%) are alive in remission 24-149 months (median 67) after transplantation (75 in continuous remission and four after further therapy) with Karnofsky scores of 80-100% (median 100%). The 8-year probabilities of survival, toxic death, and relapse (from the 2-year mark) are 89%, 3% and 12%. Eleven (12%) survivors had creatinine levels of > 110 μmol/l (one more than double), and 14 (16%) had bilirubin levels of > 17 mmol/l (one more than double) at the last follow-up. None of the following factors was found to be predictive for survival, non-relapse death, or relapse from the 2-year mark in multivariate analysis: age, sex, type of leukemia, disease stage, diagnosis, conditioning, origin of cells, and nucleated cell dose. We conclude that adult patients with acute leukemia who are alive and well 2 years following an autograft have a high probability of being cured, and the incidence of long-term liver and kidney dysfunction measured by serum bilirubin and creatinine is low.

Original languageEnglish (US)
Pages (from-to)875-879
Number of pages5
JournalBone Marrow Transplantation
Volume23
Issue number9
DOIs
StatePublished - 1999

Keywords

  • Acute lymphoblastic leukemia
  • Acute myeloid leukemia
  • Autologous hone marrow transplantation
  • Long-term follow-up
  • Myelodysplastic syndromes
  • Relapse

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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