Allogeneic peripheral blood stem cell transplantation for standard risk leukemia: experience of Ibni Sina Hospital

Fifty-three patients with standard risk leukemia who underwent allogeneic p eripheral blood stem cell transplantation (alloPBSCT) from their HLA-identi cal siblings were analyzed for engraftment, incidence and severity of GVHD, and relapse rate. Standard risk leukemia was defined as AML in first compl ete remission or CML in first chronic phase within the first year after dia gnosis. The median age was 34.5 years (range 13-47), Stem cells were mobili zed by using 10 mu g/kg G-CSF subcutaneously for 5 days. A median of 5.7 (2 .1-21.4) x 10(6)/kg CD34(+) cells was collected over a median of 2 (range 1 -5) apheresis procedures. Cyclosporin A (CsA) plus short-course MTX were us ed for GVHD prophylaxis. Recovery to granulocytes >0.5 x 10(9)/1 and platel ets >20 x 10(9)/l occurred at a median of day +13 (range 8-32) and +13 (ran ge 8-51), respectively. Day +100 transplant-related mortality was 13.2% (7/ 53). Acute GVHD occurred in 20 of 49 (41%) evaluable patients and only six (12.3%) of them had severe disease (grade III-IV). Chronic GVHD occurred in 30 of 42 (71.4%) evaluable patients. Relapse rate at 2 years was 7.5%. The median overall and leukemia-free survivals were 22 (4-44) and 20 (3-44) mo nths, respectively. Estimated 4 year leukemia-free and overall survival rat es were 60% and 62%, respectively. In conclusion, alloPBSCT in standard ris k leukemia seems to be associated with a low relapse rate and no increased risk of acute GVHD, but there is a trend for higher incidence of cGVHD.