Long term follow up after allogeneic stem cell transplantation for chronicmyelogenous leukemia

Citation
E. Reiter et al., Long term follow up after allogeneic stem cell transplantation for chronicmyelogenous leukemia, BONE MAR TR, 22, 1998, pp. S86-S88
Citations number
3
Categorie Soggetti
Hematology,"Medical Research Diagnosis & Treatment
Journal title
BONE MARROW TRANSPLANTATION
ISSN journal
02683369 → ACNP
Volume
22
Year of publication
1998
Supplement
4
Pages
S86 - S88
Database
ISI
SICI code
0268-3369(199812)22:<S86:LTFUAA>2.0.ZU;2-S
Abstract
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.