Allogeneic Bone Marrow Transplantation in Korea: 1983-92

Abstract

Between March 1983 and December 1992, we performed 178 allogeneic BMTs for patients with hematopoietic stem cell disorders: 48 acute myelogenous leukemia (AML), 27 acute lymphoblastic leukemia (ALL), 40 chronic myelogenous leukemia (CML), 55 severe aplastic anemia (SAA), 6 myelodysplastic syndrome (MDS), 1 non-Hodgkin's lymphoma and 1 hybrid leukemia. Twenty-five of 48 AML are in disease-free survival (DFS). Fifteen of 27 ALL are in unmaintained remission. Twenty-four of 40 CML are in DFS. Fortyfour out of 55 SAA patients are alive and well. Comparing the survival between standard (less than or equal to CR1: 21 of 31 (68%)) and high risk (greater than or equal to CR2: 4 of 17 (24%)) AML, our data suggest that the preparative regimen for high risk AML was not potent enough to eradicate the residual disease in advanced AML. Although our cases are limited and the follow-up period is short, the result of ALL (overall: 56%, standard risk (adult less than or equal to CR1, children less than or equal to CR2: 10 of 14 (71%) and high risk (adult greater than or equal to CR2, children > CR2): 5 of 13 (38%)) and CML (overall: 60%; CP: 19 of 27 (70%), AP or BC: 5 of 13 (38%)) are promising. The probability of 5 year survival of SAA was 80+/-4 years. The causes of death were relapse of leukemia (28 of 62, 44.4%) and rejection or engraftment failure (13 of 62, 21.6%), TTP-like syndrome (n = 6), sepsis (n = 4), acute GVHD (n = 3, NS) and interstitial pneumonia (IP; n=3), obliterative bronchiolitis (n = 2), VOD (n = 2) and acute renal failure (n = 1). The incidence in death due to IP and acute GVHD was lower than that in other reports. The relatively high incidence in leukemia relapse emphasizes the need for better conditioning regimens.