HIGH-INCIDENCE OF CHRONIC GVHD AFTER PRIMARY ALLOGENEIC PERIPHERAL-BLOOD STEM-CELL TRANSPLANTATION IN PATIENTS WITH HEMATOLOGIC MALIGNANCIES

To assess feasibility and potential advantages of PBSC allograft, we t ransplanted nine patients (age 20-47 years) with advanced or poor-risk hematologic malignancies, These included eight HLA-identical sibling transplants and one partially matched, Cells were collected from donor s by apheresis after rh-G-CSF 10-16 mu g/kg/day for 4-5 days, and stor ed at 4 degrees C until infusion, Patients were conditioned with busul fan 16 mg/kg and cyclophosphamide 200 mg/kg, and received GVHD prophyl axis with CSA-MTX, The graft consisted of PBSC alone, with a median of 101.2 (range 28-254.2) x 10(4)/kg CFU-GM, 6.84 (range 4.57-15.9) x 10 (6)/kg CD34(+) cells and 2.5 (range 1.2-6) x 10(8)/kg CD3(+) cells, An ANC > 0.5 x 10(9)/l occurred on (median) day 13 (range 11-17), and a platelet count > 50 x 10(9)/l on (median) day 15 (range 12-29) post gr aft, One patient died of ARDS on day 13, the others are alive 96-485 ( median 245) days from the graft, Two patients have relapsed, one of th em with isolated CNS involvement, Acute GVHD (grade I-II) occurred in three patients and severe chronic GVHD in six patients, with no relati onship to CSA withdrawal, This unexpected incidence of chronic GVHD mi ght be linked to the high number of CD3(+) cells in the graft, contrib uting to a favourable GVL effect.