MARROW TRANSPLANTATION FOR PATIENTS IN ACCELERATED PHASE OF CHRONIC MYELOID-LEUKEMIA

The records were reviewed of 58 patients receiving transplants in Seat tle with unmanipulated marrow from HLA-identical siblings during the a ccelerated phase (AP) of chronic myeloid leukemia. Variables examined for association with survival and relapse included the interval from d iagnosis to transplant, the reasons for categorization as AP, age, reg imen, and cytomegalovirus serology. Four patients relapsed. The 4-year probabilities of survival, relapse-free survival, nonrelapse mortalit y, and relapse were 0.49, 0.43, 0.51, and 0.12, respectively. After co mpletion of the stepwise multivariate analysis, age less than 38 years and categorization as AP solely on the basis of chromosomal abnormali ties emerged as being independently significantly associated with impr oved survival. The 4-year probability of survival for the 16 patients categorized as AP because of chromosomal abnormalities and receiving t ransplant less than 1 year from diagnosis was 0.74. The low probabilit y of relapse in these patients suggests that more aggressive preparati ve regimens are not indicated for patients receiving transplants in AP because of the increased risk of transplant-related mortality. (C) 19 94 by The American Society of Hematology.