Transplantation In Second Remission Research Articles

106 patients with acute lymphoblastic leukaemia (ALL) who received bone-marrow transplants from HLA-identical siblings during first or second remission had an actuarial survival rate at 4 years of 43±12% and an actuarial relapse rate of 32±12%. 98 patients with more advanced disease had a significantly lower probability of survival (15±9%) and a significantly higher probability of relapse (67±14%). Among high-risk patients, those transplanted in first remission had a higher survival probability (55±22%) than those transplanted in second remission (41±15%). Relapse rates in the two groups were comparable (28±24% and 31±19% respectively). Standard-risk and high-risk patients transplanted in second remission had comparable relapse rates, but there was a trend towards higher survival probability in standard-risk patients. Thus long-term disease-free survival in ALL can be achieved with bone-marrow transplantation. It is not yet certain whether transplants in first remission will result in higher survival rates than transplants in second remission; relapse rates were similar in the two groups.

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