Between January 1983 and July 1997, 83 patients (35 female, 48 male) with a
median age of 37 (19-57) years with chronic myelogenous leukemia (CML) wer
e admitted for bone marrow transplantation (BMT) at the University hospital
of Vienna. Fifty-six patients were in chronic phase, 17 in accelerated and
10 had blast crisis. Marrow donors were: HLA-identical siblings in 62 pati
ents, 2-antigen mismatched related donor in 2, HLA-identical unrelated dono
rs (MUD) in 17 and 1-antigen mismatched unrelated donor in 2 patients. The
median time from diagnosis to BMT was 22 (2-91) months. Conditioning therap
y consisted of cyclophosphamide (Cr) and total body irradiation or CY and b
usulfan. For graft-versus-host disease (GVHD) prophylaxis methotrexate (MTX
) alone, MTX and cyclosporine A (CSA), CSA alone or CSA and methylprednison
e were given. Durable engraftment was documented in 75 of 77 patients (97%)
. As of July 31, 1997 48 patients are alive (58%), 36 (56%) after sibling t
ransplantation with a median observation time of 77 months and 12 (63%) aft
er MUD transplantation with a median observation time of 13 months. Overall
survival for patients in chronic phase (CP) at time of BMT is 64% 53% for
patients in acceleration and 30% for patients in blast crisis (BC). Disease
-free survival (DFS) after sibling BMT and unrelated donor transplantation
is 53% and 58%, respectively. Ten patients (12%) experienced relapse of CML
. Transplant-related mortality was 33% after sibling and 32% after MUD tran
splantation. Thus, sibling and unrelated donor BMT offer high cure rates wi
th acceptable toxicity to patients with CML.