TRANSPLANTATION OF ALLOGENEIC PERIPHERAL-BLOOD STEM-CELLS AFTER MYELOABLATIVE TREATMENT OF A PATIENT IN BLASTIC CRISIS OF CHRONIC MYELOCYTIC-LEUKEMIA

A 48-year old man in blastic crisis of chronic myelocytic leukemia rec eived a transplant of allogeneic peripheral blood stem cells. The dono r was his HLA-identical sister, who refused to donate bone marrow cell s, but agreed to donate peripheral blood stem cells. The patient recei ved standard transplant conditioning with cyclophosphamide (120 mg/kg) and busulfan (16 mg/kg). Peripheral blood stem cells were mobilized w ith granulocyte colony stimulating factor and collected by apheresis. After transplantation, the white blood cell count and the result of mi croscopic analysis of the bone marrow became normal, and the leukocyte karyotype became 46XX. DNA fingerprinting showed complete chimerism. Graft-versus host disease was suppressed with cyclosporine and methylp rednisolone. The patient died of recurrence of leukemia on day 102+. ( C) 1994 Wiley-Liss, Inc.