|
|
 Previous Article | Table of Contents | Next Article 
Therapy for chronic myelogenous leukemia with unrelated donor bone marrow
transplantation: results in 102 cases [published erratum appears in Blood
1990 Aug 1;76(3):654]
PB McGlave, P Beatty, R Ash and JM Hows
University of Minnesota Medical School, Minneapolis.
From April, 1985, to February, 1989, 102 consecutive patients received
unrelated donor bone marrow transplantation therapy for chronic myelogenous
leukemia (CML) at four centers. Median age of the group was 31 years
(range, 4.5 to 51 years). Fifty-four patients were in first chronic phase
(CP) at time of transplantation, and 48 had evidence of more advanced
disease (AD) (accelerated phase, 32; blast crisis, 9; second CP, 7). In 44
cases, the donor and recipient were identical at the HLA A, B, and DR loci
and were nonreactive in bidirectional mixed leukocyte culture (MLC)
("matched"). In 58 cases, nonidentity between donor and recipient could be
determined at at least one HLA locus or in bidirectional MLC
("mismatched"). Fifty-eight patients were prepared for transplantation with
a combination of cyclophosphamide and fractionated total body irradiation
(FTBI) and received acute graft- versus-host disease (GVHD) prophylaxis
consisting of methotrexate alone or in combination with cyclosporine,
prednisone, or antithymocyte globulin (ATG). In 44 cases, patients received
preparative agents in addition to cyclophosphamide and FTBI, and marrow
depleted of mature T lymphocytes by ex vivo incubation with either anti-CD3
antibody plus complement (n = 24) or Campath-1 (n = 20). Engraftment
defined by a peripheral blood neutrophil count greater than 0.5 X 10(9)/L
was demonstrated in 92 cases and occurred at a median of 22 days (range, 11
to 46 days). In 10 cases, peripheral blood evidence of engraftment did not
occur, and in one case, engraftment was followed by aplasia. Hematologic
relapse was seen in four cases. Recurrence or persistence of the Ph1
chromosome without evidence of hematologic relapse occurred in four
additional cases. The incidence of grade II to IV acute GVHD is 65% (95%
confidence interval [CI], +/- 10%). After adjustment for recipient age and
donor matching status, recipients of T lymphocyte- depleted donor marrow
had a significantly lower incidence of grade II to IV acute GVHD (P less
than .01); however, T depletion was not significantly associated with
improved survival (P = .34), disease-free survival (P = .51), or increased
incidence of relapse (P = .39). Of 102 patients, 46 are alive, with a
median survival of 12 months (range, 3 to 46 months), and the Kaplan-Meier
estimate of disease-free survival is 29% (95% CI, +/- 9%) for the entire
group at 2 1/2 years.(ABSTRACT TRUNCATED AT 400 WORDS)
Volume 75,
Issue 8,
pp. 1728-1732,
04/15/1990
Copyright © 1990 by The American Society of Hematology
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati What's this?
This article has been cited by other articles:
|
|
|
|
 
D. J. Weisdorf, C. Anasetti, J. H. Antin, N. A. Kernan, C. Kollman, D. Snyder, E. Petersdorf, G. Nelson, and P. McGlave
Allogeneic bone marrow transplantation for chronic myelogenous leukemia: comparative analysis of unrelated versus matched sibling donor transplantation
Blood,
March 15, 2002;
99(6):
1971 - 1977.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. B. McGlave, X. O. Shu, W. Wen, C. Anasetti, A. Nademanee, R. Champlin, J. H. Antin, N. A. Kernan, R. King, and D. J. Weisdorf
Unrelated donor marrow transplantation for chronic myelogenous leukemia: 9 years' experience of the National Marrow Donor Program
Blood,
April 1, 2000;
95(7):
2219 - 2225.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
Monitoring Treatment and Survival in Chronic Myeloid Leukemia
J. Clin. Oncol.,
June 1, 1999;
17(6):
1858 - 1858.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
F.X. Mahon, C. Faberes, S. Pueyo, P. Cony-Makhoul, R. Salmi, J.M. Boiron, G. Marit, C. Bilhou-Nabera, A. Carrere, M. Montastruc, et al.
Response at Three Months Is a Good Predictive Factor for Newly Diagnosed Chronic Myeloid Leukemia Patients Treated by Recombinant Interferon-alpha
Blood,
December 1, 1998;
92(11):
4059 - 4065.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. J. Morton, T. Gooley, J. A. Hansen, F. R. Appelbaum, B. Bruemmer, J. W. Bjerke, R. Clift, P. J. Martin, E. W. Petersdorf, J. E. Sanders, et al.
Association Between Pretransplant Interferon-alpha and Outcome After Unrelated Donor Marrow Transplantation for Chronic Myelogenous Leukemia in Chronic Phase
Blood,
July 15, 1998;
92(2):
394 - 401.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. A. Hansen, T. A. Gooley, P. J. Martin, F. Appelbaum, T. R. Chauncey, R. A. Clift, E. W. Petersdorf, J. Radich, J. E. Sanders, R. F. Storb, et al.
Bone Marrow Transplants from Unrelated Donors for Patients with Chronic Myeloid Leukemia
N. Engl. J. Med.,
April 2, 1998;
338(14):
962 - 968.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. W. Petersdorf, G. M. Longton, C. Anasetti, E. M. Mickelson, S. K. McKinney, A. G. Smith, P. J. Martin, and J. A. Hansen
Association of HLA-C Disparity With Graft Failure After Marrow Transplantation From Unrelated Donors
Blood,
March 1, 1997;
89(5):
1818 - 1823.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. Silberman, M. G. Crosse, E. A. Peterson, R. C. Weston, M. M. Horowitz, F. R. Appelbaum, and B. D. Cheson
Availability and Appropriateness of Allogeneic Bone Marrow Transplantation for Chronic Myeloid Leukemia in 10 Countries
N. Engl. J. Med.,
October 20, 1994;
331(16):
1063 - 1067.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
N. A. Kernan, G. Bartsch, R. C. Ash, P. G. Beatty, R. Champlin, A. Filipovich, J. Gajewski, J. A. Hansen, J. Henslee-Downey, J. McCullough, et al.
Analysis of 462 Transplantations from Unrelated Donors Facilitated by the National Marrow Donor Program
N. Engl. J. Med.,
March 4, 1993;
328(9):
593 - 602.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
M. J. Hanigan
Unrelated Bone Marrow Transplantation and the National Marrow Donor Program: An Update
Journal of Pediatric Oncology Nursing,
January 1, 1992;
9(2):
71 - 75.
[PDF]
|
|
|
|
|
|
|
M. J. Hanigan
Unrelated Bone Marrow Transplantation: Past, Present, and Future
Journal of Pediatric Oncology Nursing,
January 1, 1991;
8(2):
80 - 81.
[PDF]
|
|
|
|
|
