Bone marrow transplantation for acute myelogenous leukemia. Factors associated with early mortality
M. M. Bortin, R. P. Gale, H. E. Kay and A. A. Rimm
Comprehensive data were reported to the International Bone Marrow
Transplant Registry, Milwaukee, regarding 156 patients with acute
myelogenous leukemia who were treated with allogeneic bone marrow
transplantation between 1978 and 1980. The minimum observation period was
15 months after transplant and most deaths occurred within the first six
months. Prognostic factors were evaluated for associations with early
mortality or life-threatening complications. Most early deaths were due to
infections, interstitial pneumonitis, and graft-v-host disease (GVHD).
Multivariate analyses disclosed five factors with significant associations
with early death or a major cause of early death: (1) disease status; (2)
dose-rate of irradiation; (3) drug used to prevent GVHD; (4) severity of
GVHD; and (5) dose of marrow cells. It is emphasized that several of the
important prognostic factors are within the control of the referring
physician or the transplant team.
