Consolidation Treatment of Adult Acute Lymphoblastic Leukemia: A Prospective, Randomized Trial Comparing Allogeneic Versus Autologous Bone Marrow Transplantation and Testing the Impact of Recombinant Interleukin-2 After Autologous Bone Marrow Transplantation

• Published in: Blood 1995-08, Vol.86 (4), p.1619-1628
• Main Authors: Attal, Michel, Blaise, Didier, Marit, Gerald, Payen, Catherine, Michallet, Mauricette, Vernant, Jean-Paul, Sauvage, Catherine, Troussard, Xavier, Nedellec, Gerard, Pico, Jose, Huguet, Frangoise, Stoppa, Anne Marie, Broustet, Antoine, Sotto, Jean-Jacques, Pris, Jacques, Group, Dominique Maraninchi, and Josy Reiffers for the BGMT
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Hematologic and hematopoietic diseases; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Medical sciences
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood.V86.4.1619.bloodjournal8641619

A prospective, randomized trial was initiated in adult acute lymphoblastic leukemia (ALL) to compare (1) disease-free survival (DFS) after allogeneic or autologous bone marrow transplantation (BMT) and (2) the relapse rate of patients treated with or without interleukin-2 (IL-2) after autologous BMT. A total of 135 previously untreated patients, aged under 55 years, received the Berlin-Frankfurt-Muster (BFM) induction regimen: 126 patients (93%), of which 120 were HLA-typed, achieved complete remission (CR). According to this genetic randomization, patients with (n = 43) or without an HLA-identical sibling (n = 77) were to receive allogeneic or autologous BMT, respectively. The 3-year post-CR probability of DFS was significantly higher in the HLA-identical sibling group than in the non-HLA-identical sibling group (68% v 26%; P < .001). Eligible patients were randomized to receive (n = 30) or not to receive (n = 30) IL-2 after autologous BMT: the 3-year post-BMT probability of continuous CR was similar in both groups (29% v 27%, respectively). We conclude that, in ALL, early allogeneic BMT after the BFM induction regimen is an effective consolidation treatment and that IL-2 does not decrease the high relapse rate observed after autologous BMT.