Allogeneic peripheral blood stem cell transplantation in 23 adult patientswith hematologic malignancies: A single-center experience

We describe a single-center experience of 23 consecutive patients (median a ge, 35 years) with hematologic malignancies who received allogeneic periphe ral blood stem cell transplants (alloPBSCTs) from HLA-identical siblings. T en patients had standard-risk disease and 13 had high-risk disease. Twenty- one patients received alloPBSCT as a primary transplant, and the remaining 2, with high-risk disease, as a second transplant after posttransplantation relapse. All donors received daily subcutaneous injections of granulocyte colony-stimulating factor at a dose of 10 mug/kg, and peripheral blood stem cells were collected by 1 to 3 aphereses. Median numbers of CD34(+) and CD 3(+) cells infused were 5.8 x 10(6)/kg (range, 1.3-19.7 x 10(6)/kg) and 4.9 x 10(8)/kg (range, 1.9-8.6 x 10(8)/kg), respectively. Graft-versus-host di sease (GVHD) prophylaxis consisted of cyclosporin A (CyA) and methotrexate (18 patients) or CyA and methylprednisolone (5 patients). Rapid hematologic engraftment was observed in 20 of the 23 patients. Median days to absolute neutrophil counts >0.5 x 10(9)/L and platelet counts >20 x 10(9)/L were 12 (range, 9-18 days) and 14 (range, 10-128 days), respectively. Acute GVHD o f grade 2-4 was observed in 6 of 20 evaluable patients (30%) and extensive chronic GVHD in 8 of 15 evaluable patients (53%). Ten of the 23 patients (4 4%) were surviving in continuous complete remission 191 to 1492 days (media n, 643 days) posttransplantation. Treatment-related death within 100 days p osttransplantation was observed in 6 of the 23 patients (26%). Six of the 2 3 patients (26%) developed relapse at a median 81 days (range, 38-160 days) posttransplantation. Further study is needed to assess the precise benefit s of alloPBSCT compared with allogeneic bone marrow transplantation. Int J Hematol. 2000;72:362-370. (C) 2000 The Japanese Society of Hematology.