A comparison of marrow transplantation with chemotherapy for children with acute lymphoblastic leukemia in second or subsequent remission
Abstract
The progress of 24 children with acute lymphoblastic leukemia treated with cyclophosphamide, total-body irradiation, and marrow transplantation during a second or subsequent remission was compared with that of 21 children treated with conventional chemotherapy after they had entered a second remission. Eleven of the transplantation group are alive, including nine in continuing complete remission for 17 to 55 months; only two of the chemotherapy group are alive, one in complete remission after 20 months. Relapse was the major cause of failure in both groups. Acute and chronic graft-versus-host disease in the transplantation group and leukoencephalopathy in both groups were the other major causes of morbidity and mortality. This study demonstrates that marrow transplantation currently offers the best chance of long-term remission and potential cure after a child with acute lymphoblastic leukemia has had a relapse in the marrow.
References
Methotrexate regimens for control of graft-versus-host disease in dogs with allogeneic marrow grafts
Citations
Bone-marrow transplantation in high-risk acute lymphoblastic leukaemia in first and second remission
Outcome of bone marrow transplantation in patients with extramedullary involvement of acute leukemia
Acute lymphoblastic leukemia in children: an update of clinical, biological, and therapeutic aspects
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