ENGRAFTMENT FOLLOWING MITOXANTRONE (MITO) BASED CONDITIONING FOR ALLOGENEIC BONE-MARROW TRANSPLANTATION (ALLO-BMT)

Mitoxantrone (Mito) is presently used in an increasing number of malig nancies including leukemias, breast carcinomas and solid tumors. With it has come increased incidence of post remission cytopenias and delay ed engraftment following autologous bone marrow transplantation (ABMT) . We evaluated engraftment in 18 patients who underwent allogeneic BMT (allo-BMT) following a preparative regimen that included high dose Mi te (60 mg m(2)). Sixteen patients with malignant disease (AML 10, ALL 3, CML 2, MDS 1) and two with non-malignant disease (SCID 1, osteopetr osis 1) underwent non-T cell depleted allo-BMT. Fourteen patients with malignancies were transplanted at an advanced stage of disease while only two patients were standard risk patients. Of the 18 patients, 12 were females and six males, with a median age of 30.5 (0.3-48) years. Nine patients, (breast cancer 3, malignant lymphoma 4 and AML 2), who underwent ABMT following preparative regimens with comparable doses of Mite, served as controls. Engraftment following allo-BMT was normal a nd not statistically different from engraftment following ABMT. Five p atients, who underwent allo-BMT, developed >grade II acute graft versu s host disease (GVHD) and two developed chronic GVHD. After a median f ollow up of 28 (6-42) months, five patients are alive tone with diseas e). In summary, engraftment following high dose Mite and allo-BMT is n ot statistically different from engraftment following ABMT. Controlled studies with a larger group of standard risk patients are needed to e lucidate the role of Mite in conditioning regimens pre-BMT. (C) 1998 E lsevier Science Ltd. All rights reserved.