Dose-reduced conditioning for allografting in 44 patients with chronic myeloid leukaemia: a retrospective analysis

Citation
M. Bornhauser et al., Dose-reduced conditioning for allografting in 44 patients with chronic myeloid leukaemia: a retrospective analysis, BR J HAEM, 115(1), 2001, pp. 119-124
Citations number
30
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Hematology,"Cardiovascular & Hematology Research
Journal title
BRITISH JOURNAL OF HAEMATOLOGY
ISSN journal
0007-1048 → ACNP
Volume
115
Issue
1
Year of publication
2001
Pages
119 - 124
Database
ISI
SICI code
0007-1048(200110)115:1<119:DCFAI4>2.0.ZU;2-M
Abstract
This retrospective study describes the outcome of patients with chronic mye loid leukaemia after allografting using dose-reduced conditioning with flud arabine and busulphan. Forty-four Philadelphia chromosome (Ph)-positive pat ients were transplanted in nine German centres; 26 patients were in chronic phase, 11 in accelerated phase and seven in blast crisis. Thirty-four pati ents achieved complete remission, with 18 alive and disease-free at a media n followup of 562 d (range 244-922 d). Grade II-IV acute graft-versus-host disease (GVHD) incidence was 43%. Twenty patients died, 15 of causes unrela ted to relapse. Risk factors predisposing to graft failure by univariate an alysis were an unrelated donor (8/23 compared with a related donor 2/21, P = 0.07) and interferon therapy within 90 d of transplant (4/6 versus 3/17, P = 0.025). At the last follow-up, of 31 patients for whom molecular or cyt ogenetic data were available, 16 (52%) were polymerase chain reaction-negat ive, and seven (23%) were Ph-negative by fluorescent in situ hybridization. These findings demonstrate that dose-reduced conditioning with fludarabine and busulphan provides durable engraftment and a low rate of relapse. Howe ver, in this population, many of whom were not eligible for high-dose condi tioning due to age, reduced performance status, previous complications or e xtensive pre-treatment, these data highlight the need for effective anti-in fectious and GVHD prophylaxis. in addition, this study supports the discont inuation of interferon therapy at least 90 d before transplant.