Long-term results of bone marrow transplantation for leukemia or aplastic anemia.

Marrow transplantation is now preferred treatment, if the patient has a suitable identical twin or HLA-identical sibling donor, for aplastic anemia, acute myelogenous or lymphoblastic leukemia that has relapsed once, and is commonly employed for the treatment of acute myelogenous leukemia in the first remission, for chronic myelogenous leukemia in the chronic phase, and for certain congenital disorders. The results of transplantation from HLA-nonidentical donors appears promising, but the follow-up is short at this time. The low incidence of relapse or nonrelapse mortality beyond the first 3-5 years with follow-up now to almost 20 years from transplantation signifies that surviving patients are cured of their disease and are likely to have survival similar to the normal population thereafter. They will probably lead normal productive lives in society. These data support applying criteria for insurance candidacy of patients who have survived more than 5 years from marrow transplantation which are similar to criteria applied to other normal individuals.