ALLOGENIC BONE-MARROW TRANSPLANTATION IN CHILDREN WITH VARIOUS ONCOHEMATOLOGICAL DISEASES

Aim. To define optimal time for transplantation of bone marrow (TBM) i n children with hematological malignancies. Materials and methods. 20 allogenic TBMs were performed in children with acute myeloblastic leuk emia (6 patients, 2 of them in recurrence), acute lymphoblastic leukem ia (7 patients, 4 of them in recurrence), chronic myeloid leukemia (CM L) in a chronic stage (3 patients), severe aplastic anemia (3 patients ), generalized neuroblastoma (1 patient). Pretransplantation preparati on included cyclophosphamide and busulphane or cyclophosphamide, busul phane and vepezide. The graft-versus-host reaction (GVHR) was prevente d with cyclosporin A plus methotrexate or cyclosporin A plus urbazone. Engrafting was recognized by change of karyotype and blood group. Res ults. From 13 children with acute leukemia subjected to TBM in a compl ete remission 4(33%) are alive, 5 died within 100 days after TBM (TBM was made in recurrence in 4 children), 3 patients died of recurrence 1 2 months after TBM. One patient with CML and one with severe aplastic anemia remain in remission. The main complications and causes of death in early posttransplantation period were hemorrhagic syndrome, infect ious complications, GVHR. According to a one-year follow-up, the recur rent disease caused death most frequently. Conclusion. Positive result of TBM is related to the disease stage at transplantation.