By F. Spreafico, A. Mantovani, R. Giavazzi, G. Conti, A. Anaclerio (auth.), Prof. G. Mathé, Dr. G. Bonadonna, Prof. S. Salmon (eds.)
Transplantation of syngeneic (donor is a monozygous dual) or allogeneic (donor is an HLA-identical sibling) marrow presents the chance for competitive antileukemic treatment with no regard to marrow toxicity. until eventually 1975, marrow transplantation used to be performed in basic terms after failure of all different treatment. for that reason, so much sufferers have been in complicated relapse. Six of sixteen recipients of syngeneic marrow and thirteen of a hundred recipients of allogeneic marrow are nonetheless in remission after five. 5-10 years [3, 7]. An actuarial survival curve of the 1st a hundred sufferers grafted in Seattle after conditioning with cyclophos phamide (60 mg/kg on each one of two successive days) and overall physique irradiation (1,000 rad) confirmed 3 sessions of curiosity: (1) the 1st four months confirmed a fast lack of sufferers linked to complex ailment, graft-versus-host disorder, infections (in specific interstitial pneumonias), and recurrent leukemia; (2) from four months to two years, the curve confirmed a far slower cost of decline attributable essentially to recurrent leukemia; and (3) from 2-10 years, the curve was once virtually flat with a negligible lack of sufferers and no recurrent leukemia. This flat part of the curve corresponded to thirteen% of the sufferers and shows a powerful likelihood that almost all of those survivors are cured in their affliction . makes an attempt at lowering the prevalence of leukemic relapse after transplantation have been made by means of a few marrow transplant teams via further chemotherapy.
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_ 2 3 5 Years Fig. 1. Global remission in groups at various risk according to Cox method mg/m 2 on days 1 and 3), cyclophosphamide (600 mg/m 2 on day 1), Ara C (100 mg/m 2 from day 1 for 5 days), and L-asparaginase (1,000 IU/kg from day 6 for 5 days) and the same combination where DNR is replaced by vincristine (2 mg/m 2). The repetition of L-asparaginase courses is justified by the observation of Onnuma and Holland  on the specificity of this enzyme for T lymphoblasts. After 6 months 6-mercaptopurine and MTX are used, with reinduction by prednisone VCR every 3 months.