ALLOGENEIC BONE-MARROW TRANSPLANTATION FOR PHILADELPHIA-CHROMOSOME-POSITIVE CHRONIC MYELOGENOUS LEUKEMIA IN CHILDHOOD

Allogeneic bone marrow transplantation (BMT) offers the only potential for long-term control of chronic myelogenous leukemia. From November 1992 to August 1994, we prospectively studied five pediatric patients with Philadelphia chromosome-positive chronic myelogenous leukemia, a unique finding in Taiwan, who were treated with allogeneic BMT at diff erent stages of the disease. Their ages at diagnosis ranged from 2 to 10 years. Four donors were HLA-matched siblings and the other was an H LA-matched unrelated donor. All patients received busulfan (4 mg/kg/da y for 4 days) followed by cyclophosphamide (60 mg/kg/day for 2 success ive days) as the conditioning regimen. Engraftment was documented with in 22 days after transplantation in all five patients. Two our of the four patients in the sibling donor group, both of whom had BRIT in the first chronic phase, achieved event-free survival after follow-up for 41 months and 17 months. The other two patients, Mho had BMT in the s econd lymphoblastic crisis and the second chronic phase, died within 6 months after transplantation due to lymphoid blastic crisis and compl ication of cytomegaloviral pneumonitis, respectively. The patient who received marrow from the unrelated donor underwent BRIT in the acceler ated phase and died within 6 months after transplantation due to myelo id blastic crisis. In conclusion, allogeneic BRIT performed in the fir st chronic phase of childhood Philadelphia chromosome-positive chronic myelogenous leukemia seems to have better results than BMT after the first chronic phase.