Bone Marrow Transplantation for Minimal Residual Disease in Leukemia

Abstract

Between 1974 and March 1979 we transplanted 18 patients with terminal drug-resistant acute leukemia. 17 patients died. 14 of them died without evidence of disease due to transplant related complications e.g. Graft-versus-Host-Disease and interstitial pneumonia. Three died of leukemic relapse. One patient survived and is today eight years after transplantation leading a normal life (1). These results confirmed those obtained by others (2): Marrow transplantation could cure leukemia resistant to chemotherapy, complications however were too frequent in terminally ill patients. In summer 1979 we initiated a new program. We tried to transplant patients under optimal conditions: patients with acute leukemia in first remission. Such patients are clinically healthy and have a minimal tumor load. In this new series of patients Cyclosporine (CyA) was used for prophylaxis of Graft-versus-Host-Disease (GvHD) (3). We continued to transplant patients in later stages of their disease or patients who never gained remission. The aim of this study was to test if earlier transplantation could indeed reduce both, transplant related and disease related mortality. Incidently we began to transplant patients with chronic myelogenous leukemia in chronic phase in 1979 (4).

Supported by Grants of the Swiss Science Foundation 3.846. 0.79 and the Swiss Cancer League 4141.LR79 and the Swiss Public Health Service.