학술논문
Reduced-intensity conditioning using TBI (8?Gy), fludarabine, cyclophosphamide and ATG in elderly CML patients provides excellent results especially when performed in the early course of the disease.
Document Type
Article
Author
Source
Subject
*BONE marrow
*IMMUNOSUPPRESSIVE agents
*STEM cells
*TRANSPLANTATION of organs, tissues, etc.
*MYELOID leukemia
*ANTINEOPLASTIC agents
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Language
ISSN
0268-3369
Abstract
Summary:Allogeneic bone marrow or stem cell transplantation is a curative therapeutic option for chronic myelogenous leukemia. In order to decrease the toxicity of the procedure, the dosage of total body irradiation was reduced from 12 to 8?Gy and subsequently the dose of cyclophosphamide from 120 to 80?mg/kg. The purine analogue fludarabine, ATG, cyclosporine A and a short course of methotrexate were given for immune suppression. So far, 35 elderly CML patients with sibling and unrelated donors have been transplanted. Transplant-related mortality at day+100 was 11%. After engraftment, all patients achieved a complete cytogenetic remission. Relapse occurred in 14%of the patients. The risk of relapse was significantly higher in those patients transplanted in second chronic or accelerated phase (P=0.048). After a median follow-up of 30 months (range 12-62), 63%of the patients are alive. Those patients transplanted within the first year from diagnosis had an overall survival of 79%(P=0.049), emphasizing the benefit of early transplantation. Stepwise reduction of conditioning intensity resulted in stable engraftment, low relapse rates and encouraging overall survival in this high-risk patient group.Bone Marrow Transplantation (2004) 34, 1083-1088. doi:10.1038/sj.bmt.1704664 Published online 18 October 2004 [ABSTRACT FROM AUTHOR]