TREATMENT OF LEUKEMIA WITH PARTIALLY MATCHED RELATED BONE-MARROW TRANSPLANTATION

The results of partially matched related donor (PMRD) marrow transplan tation for 82 patients with leukemia are reported, including 45 who re ceived two antigen disparate grafts, Following intensive radiochemothe rapy, patients received grafts which were partially depleted of T cell s by the monoclonal antibody T10B9 and complement, Actuarial probabili ty of engraftment was 86% (95% CI = 78-93%), The median day to engraft ment was similar among recipients of grafts disparate at one, two or t hree antigen loci, The incidence of severe (grades III and IV) acute g raft-versus-host disease and extensive chronic graft-versus-host disea se was 13% and 6%, respectively, The probability of disease-free survi val for the entire cohort of patients is 31% at 3 years, Age less than or equal to 30 years, early or intermediate stage disease and a graft disparate at one or two loci predicted longer disease-free survival i n multivariant analysis, Moreover, 47% of patients receiving PMRD graf ts disparate at two loci who had both these favorable pretransplant ch aracteristics were alive and free of disease 3 years after transplanta tion. We believe that the utilization of PMRDs, especially those with two antigen disparate grafts, can extend allogeneic transplantation to additional leukemic patients lacking a histocompatible donor, with ac ceptable results.