Bone marrow transplantation from HL-A-matched donors to patients with acute leukemia: Toxicity and antileukemic effect

Eleven HL-A antigen- and mixed leukocyte culture (MLC) -matched sibling bone marrow transplants were attempted in nine multiply transfused acute leukemia patients to define the toxicities of the immunosuppressive regimens and the complications associated with marrow engraftment. All patients but one were considered refractory to conventional chemotherapy. Eight of the nine patients were engrafted as indicated by a change to donor red blood cell (RBC) type, leukocyte karyotype, immunoglobulin allotype, or by the speed of marrow repopulation and/or occurrence of the graft-versus-host reaction (GVHR). The median duration of remission in the patients successfully engrafted was 67 days (range 10-132) and the median survival of all patients following preparation for marrow transplantation was 90 days (20-602). Two of four patients who developed GVHR died in remission. Four patients developed cytomegalovirus (CMV) infection during the post-transplant period.