HAPLOIDENTICAL BONE-MARROW TRANSPLANTATION FROM MOTHER-TO-CHILD WITH ADVANCED LEUKEMIA

Use of the mother as mismatched marrow donor was assessed in 19 childr en with advanced leukemia, Patients were homogeneous for HLA incompati bility, age, donor, and conditioning regimen, and stage of disease. Al l received busulfan and cytoxan, combined with unmodified donor marrow , ALG given before and after transplant, and short MTX and cyclosporin e as GVHD prophylaxis. Survival, LFS, and relapse respectively were 26 , 26, and 33%. Incidence of overall and severe acute GVHD was 58 and 3 2%, respectively. Four patients had failure of engraftment, and two of these are alive with autologous reconstitution in complete remission. Probability of rejection was 21%. Results of haploidentical transplan ts were compared with those of children with advanced leukemia treated at the same institution, who received marrow from HLA-identical sibli ngs. The probability of long-term leukemia-free survival was similar i n the two groups. We thus propose using the mother as an alternative m arrow donor in children with advanced leukemia.