A new preconditioning regimen with melphalan, busulphan and total body irradiation followed by low-dose immunosuppressant in allogeneic haemopoietic stem cell transplantation

Twenty adult patients with high-risk leukaemia underwent allogeneic haemopo ietic stem cell transplantation after melphalan, busulphan and total body i rradiation followed by short-term methotrexate and low-dose cyclosporine or tacrolimus. Three patients developed veno-occlusive disease and no patient developed renal dysfunction, Seven patients experienced grade II-IV acute graft-versus-host disease (aGVHD) and five patients experienced grade III-I V. The 3-year probabilities of relapse and leukaemia-free survival were 22 +/- 11% (95% confidence interval) and 50 +/- 11%, respectively, These data suggest that this preconditioning regimen followed by a low-dose immunosupp ressant provided a more anti-leukaemic effect without increased regimen-rel ated toxicity and aGVHD.