The influence of early transplantation, age, GVHD prevention regimen, and other factors on outcome of allogeneic transplantation for CML following BuCy

Results in 164 patients who underwent allogeneic marrow transplantation fol lowing busulfan and cyclophosphamide over a 15 year period were analyzed. A ge (median 37, range 14-66 years) did not significantly affect the incidenc e of graft-versus-host disease (GVHD), but patients who received methotrexa te with cyclosporine had a significantly lower incidence (P = 0.002) of chr onic GVHD compared to those who received methylprednisolone with cyclospori ne. Hepatic veno-occlusive disease (VOD) occurred less frequently in chroni c phase patients (P = 0.002) and in those transplanted shortly after diagno sis (P = 0.001). Five year leukemia-free survival (LFS) for the entire grou p was 49% (95% CI 41-57%), For 102 patients who underwent transplantation i n chronic phase, results were significantly improved by transplantation at a short interval following diagnosis, particularly within 3 months (P = 0.0 1), by the use of methotrexate and not corticosteroids for GVHD prevention (P = 0.03), and by use of HLA-identical sibling donors (P = 0.01), Age was not a significant adverse prognostic factor and transplantation was success fully performed in individuals up to age 66, Allogeneic transplantation in CML, including older patients and those with unrelated donors, can be most safely and effectively performed shortly after diagnosis.