BIG BU CY IS ASSOCIATED WITH A FAVORABLE LONG-TERM OUTCOME IN PATIENTS ALLOTRANSPLANTED FOR CHRONIC MYELOGENOUS LEUKEMIA IN CHRONIC PHASE/

Twenty-six adult patients, median age 36 years (range 21-53) with chro nic myeloid leukemia in first chronic phase were allotransplanted betw een October 1989 and May 1995, The preparative regimen consisted of bu sulphan 16 mg/kg and cyclophosphamide 200 mg/kg (big BU/CY), Cyclospor in A and methotrexate were used for GVHD prophylaxis, Twenty-two donor s were HLA-identical siblings and four donors were mismatched for one antigen of class I, The global incidence of acute GVHD was 50%, that o f severe aGVHD (grades 3-4) was 11%; the global incidence of chronic G VHD was 30%, No patients developed veno-occlusive disease of the liver or interstitial pneumonia, Five patients died, one of relapse, four o f transplant-related causes, mostly related to aGVHD; thus, the transp lant-related mortality was 16%, Twenty-one patients are alive, in remi ssion, with a median follow-up of 55 months (range 24-90); actuarial p robability of survival is 78% (CI 64-96), Our study shows that this co nditioning regimen is relatively easy to administer and seems to be as effective as, if not superior to, regimens containing TBI, in patient s with chronic myeloid leukemia in chronic phase and the transplant-re lated mortality is not excessive even in older patients.