Objective: To study the effect of nonmyeloablative peripheral blood stem cell transplantation(PBSCT) for chronic myelogenous leukemia(CML) in chronic phase(CML-CP) and advanced phase(CML-AP).

Methods: Twenty-four CML patients, 16 in CML-CP and 4 in CML-AP underwent nonmyeloablative peripheral blood stem cell transplantation(NST). The conditioning regimen included fludarabine 30mg.m−2.d−1, intravenously(i.v.)×6d, busulphan 4mg.m−2.d−1×2d and CTX 350mg.m−2.d−1×2d combined with or without Ara-C. The donors were HLA-identical (n=20) and 5/6 antigen-matched (n=4).

Results: All the patients were successfully engrafted. The mean time needed for increase of the number of neutrophils to more than 0.5×109/L and platelet more than 20×109/L were 13 days and 11.5 days respectively. Among 12 patients, 9 showed complete donor chimerism(CDC) and 3 showed mixed chimerism(MC) at +day 30. At +day 180, 18 patients still alive showed CDC and remained alive after a median follow-up of 24 months (4∼48months). 3 cases died of severe acute GVHD(aGVHD), 1 case of chronic GVHD(cGVHD), 2 cases of interstitial pneumonia(IP) and 1 case of relapse.

Conclusion: Nonmyeloablative PBSCT is an effective method for CML patients in chronic phase and advanced phase.

Characteristics of 24 CML patients and their donors

PatientAgeGenderDiagnosisDonorHLA
*: unrelated donor 
1 40 male CML-AP brother HLA-identical 
2 32 male CML-AP brother HLA-identical 
3 40 male CML-CP brother HLA-identical 
4 40 male CML-CP brother HLA-identical 
5 42 male CML-AP brother HLA-identical 
6 24 male CML-AP sister HLA-identical 
7 55 male CML-CP sister HLA-identical 
8 32 male CML-CP brother HLA-identical 
9 36 male CML-CP brother HLA-identical 
10 46 female CML-AP sister HLA-identical 
11 52 female CML-CP brother HLA-identical 
12 60 male CML-CP sister HLA-identical 
13 45 female CML-CP brother HLA-identical 
14 48 male CML-CP brother HLA-identical 
15 33 male CML-CP URD* HLA-identical 
16 35 female CML-CP URD HLA-identical 
17 40 male CML-CP brother HLA-identical 
18 34 female CML-AP sister HLA-identical twin 
19 54 female CML-CP brother HLA-identical 
20 33 male CML-AP URD Subtype mismatched 
21 32 male CML-CP URD Subtype mismatched 
22 42 male CML-CP URD mismatched 
23 50 female CML-CP URD HLA-identical 
24 46 male CML-CP brother HLA-identical 
PatientAgeGenderDiagnosisDonorHLA
*: unrelated donor 
1 40 male CML-AP brother HLA-identical 
2 32 male CML-AP brother HLA-identical 
3 40 male CML-CP brother HLA-identical 
4 40 male CML-CP brother HLA-identical 
5 42 male CML-AP brother HLA-identical 
6 24 male CML-AP sister HLA-identical 
7 55 male CML-CP sister HLA-identical 
8 32 male CML-CP brother HLA-identical 
9 36 male CML-CP brother HLA-identical 
10 46 female CML-AP sister HLA-identical 
11 52 female CML-CP brother HLA-identical 
12 60 male CML-CP sister HLA-identical 
13 45 female CML-CP brother HLA-identical 
14 48 male CML-CP brother HLA-identical 
15 33 male CML-CP URD* HLA-identical 
16 35 female CML-CP URD HLA-identical 
17 40 male CML-CP brother HLA-identical 
18 34 female CML-AP sister HLA-identical twin 
19 54 female CML-CP brother HLA-identical 
20 33 male CML-AP URD Subtype mismatched 
21 32 male CML-CP URD Subtype mismatched 
22 42 male CML-CP URD mismatched 
23 50 female CML-CP URD HLA-identical 
24 46 male CML-CP brother HLA-identical 
View Large

Topics:
leukemia, myelocytic, chronic, peripheral blood stem cell transplantation, human leukocyte antigens, graft-versus-host disease, chronic, antepartum fetal nonstress test, antigens, busulfan, cytarabine, fludarabine, follow-up

Author notes

Disclosure: No relevant conflicts of interest to declare.

2007, The American Society of Hematology
2007
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