Allogeneic bone marrow transplantation for childhood relapsed acute lymphoblastic leukemia: comparison of outcome in patients with and without a matched family donor

Bone Marrow Transplant. 2002 Jul;30(1):1-7. doi: 10.1038/sj.bmt.1703601.


We evaluated the role of BMT in a cohort of 56 children with ALL relapsing after uniform initial treatment protocols in a single institution between 1990 and 1997. The patients were commenced on a single intensive chemotherapy regimen. All patients with a matched family donor (MFD) were recommended to receive BMT. The outcome was significantly better for patients with a MFD. The overall survival at 8 years was 60.0% (95% CI 35.7-77.6%) and 13.5% (95% CI 4.0-28.6%) for patients with and without MFDs (log-rank chi = 7.50 P = 0.0062). The event-free survival at 8 years was 55.0% (95% CI 11.1-31.3%) and 9.2% (95% CI 2.0-23.3%) for patients with and without MFDs (log-rank chi = 8.87 P = 0.0029). Multivariate analysis confirmed the survival advantage of BMT. There was no statistically significant difference in survival for patients initially relapsing within 3 years of first remission compared to children relapsing beyond 3 years. BMT provides a clear survival advantage for children following their first relapse of ALL. We recommend BMT for all children following first relapse of ALL if a MFD is available.

Publication types

  • Comparative Study
  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Bone Marrow Transplantation / immunology*
  • Bone Marrow Transplantation / mortality
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Histocompatibility*
  • Humans
  • Male
  • Nuclear Family
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / mortality
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy*
  • Recurrence
  • Survival Analysis
  • Survival Rate
  • Tissue Donors
  • Transplantation, Homologous / immunology
  • Transplantation, Homologous / mortality
  • Treatment Outcome