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Graft Versus Leukaemia

The graft-versus-leukemia effect of nonmyeloablative stem cell allografts may not be sufficient to cure chronic myelogenous leukemia

Bone Marrow Transplantation volume 32, pages 897–901 (2003)Cite this article

Summary:

We treated 12 patients with chronic myelogenous leukemia (CML) with a low-intensity preparative regimen followed by allogeneic stem cell transplantation in an attempt to confer a curative graft-versus-leukemia (GVL) effect with minimum morbidity. Seven patients in first chronic phase (CP1) and five in second chronic phase (CP2) (age 15–68 years) received a nonmyeloablative conditioning regimen of fludarabine and cyclophosphamide, followed by a G-CSF-mobilized peripheral blood stem cell (PBSC) transplant from an HLA-identical sibling. Cyclosporine (CsA) was used for graft-versus-host disease (GVHD) prophylaxis. Median follow-up was 384 days. Neutrophil recovery occurred at a median of 12 days. There was no transplant-related mortality. Of the seven CP1 patients transplanted, seven achieved a stable molecular remission; two with no post-transplant intervention, three after donor lymphocytes, imatinib and interferon, and two after a myeloablative stem cell transplant. Four of five CP2 patients died in blast crisis and one survived in molecular remission. Of the 12 patients with durable engraftment, six had Grades II–IV acute GVHD; six had limited chronic GVHD. These results suggest that cytoreduction is required to optimize the curative effect of allogeneic stem cell transplantation for CML.

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Authors and Affiliations

  1. Stem Cell Allotransplantation Section, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA

    E Sloand, R W Childs, S Solomon, A Greene, N S Young & A J Barrett

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  1. E Sloand
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  2. R W Childs
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  3. S Solomon
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  4. A Greene
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  5. N S Young
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  6. A J Barrett
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Correspondence to A J Barrett.

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Sloand, E., Childs, R., Solomon, S. et al. The graft-versus-leukemia effect of nonmyeloablative stem cell allografts may not be sufficient to cure chronic myelogenous leukemia. Bone Marrow Transplant 32, 897–901 (2003). https://doi.org/10.1038/sj.bmt.1704231

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