Reply to Shaw

✍ Scribed by Kamani, Naynesh R.; August, Charles S.

• Publisher: John Wiley and Sons
• Year: 1997
• Tongue: English
• Weight: 13 KB
• Volume: 28
• Category: Article
• ISSN: 0098-1532
• DOI: 10.1002/(sici)1096-911x(199701)28:1<78::aid-mpo17>3.0.co;2-6

✦ Synopsis

In response to the letter from Dr. Shaw, we would like Experience over the past two decades has shown that superior preparative regimens can decrease relapse rates to clarify the disease status of the patients transplanted with the TBI/cytosine arabinoside conditioning regimen. Of the post-transplantation albeit sometimes at the expense of higher regimen-related toxicity. Although ours was a pilot 14 patients with acute lymphocytic leukemia, eight patients had relapsed on therapy or within 3 months off treatment, study, our follow-up is long enough to make us feel that the communication of our experience was warranted. All 4 patients had relapsed between 7 and 19 months off treatment, and two patients were transplanted in first remission surviving patients continue to be in remission 38-108 months after transplantation (median 80 months). We due to high-risk features. Of these two, one patient had Phϩ ALL; the other presented with features of lymphoma/ agree that prospective randomized trials are necessary to address the important issues surrounding the role of leukemia, failed initial induction therapy and underwent transplantation while in remission after secondary induc-preparative regimens in transplantation for malignant diseases. Cooperative groups and international registries tion chemotherapy. At the time of bone marrow transplantation, two patients were in first remission, 10 patients should facilitate these prospective trials. were in second remission and two were in second relapse.

Naynesh R. Kamani, MD Of the six remaining patients with ANLL, five were Charles S. August, MD in first remission (3 with ANLL and 2 with acute mixed Bone Marrow Transplant Program lineage leukemia) and one with AML was transplanted Miami Children's Hospital in resistant relapse. The comparison of our results with Miami, FL 33155 those obtained by Dr. Shaw is difficult to make because of small patient numbers and different patient characteristics and also because Dr. Shaw does not tell us what thedi-