Allogeneic peripheral blood stem cell transplantation in acute non-lymphoblastic leukemia

✍ Scribed by Önder Arslan; Celalettin Üstün; Mutlu Arat; Harika Çelebi; Hamdi Akan; Meral Beksaç; Osman Ilhan; Günhan Gürman; Muhit Özcan; Nahide Konuk; Akin Uysal; Haluk Koç

• Publisher: John Wiley and Sons
• Year: 1998
• Tongue: English
• Weight: 163 KB
• Volume: 16
• Category: Article
• ISSN: 0278-0232
• DOI: 10.1002/(sici)1099-1069(199812)16:4<155::aid-hon633>3.0.co;2-0

✦ Synopsis

Unmodified allogeneic peripheral blood stem cell transplantation (alloPBSCT) was performed in 20 consecutive acute non-lymphoblastic leukemia (ANLL) patients from their HLA-identical siblings. There were 11 males and 9 females. Median age was 34 years (range 17-43). Donors were primed with 2•5-15 g/kg/day s.c. granulocyte-colony stimulating factor (G-CSF, Neupogen, Roche). Conditioning regimen was Bu (16 mg/kg)+Cy (120 mg/kg) in 19 patients and high dose Ara-C (3 gr/m 2 twice daily for 3 days) for one patient who relapsed after bone marrow transplantation. Eighteen patients were in CR1. CsA+short-term MTX (n=19) or CsA alone (n=1) were used for graft versus host disease (GVHD) prophylaxis. The median number of apheresis procedures for each patient was 2 (2-4). A median of 6•5 (3•2-38•2) 10 8 /kg MNC or 9•4 (2•2-12•4) 10 6 /kg CD34+cells were given. Median days to reach granulocyte of >0•5 10 9 /l and platelet of >50 10 9 /l were 12 (10-14) and 15 (11-35) respectively. Day 100 transplant-related mortality was 20 per cent (4/20). Grade 2 to 4 AGVHD was seen in 8 out of 17 (47%) evaluable patients. Severe AGVHD occurred in 3 out of 17 (18%). Clinical CGVHD of all grades developed in 12 out of 17 (70%) evaluable patients. The mean disease-free survival and overall survival were 17 (range: 8-33 months) and 18 months (range: 10-34 months), respectively. In conclusion, alloPBSCT in ANLL is associated with a faster engraftment, no greater incidence of AGVHD, but increased risk of CGVHD.