1. ¹BMT Service, Department of Haematology, Westmead Hospital, Westmead, New South Wales, Australia
2. ²BMT Service, Royal Melbourne Hospital, Parkville, Victoria, Australia

Correspondence: Professor M Hertzberg, Department of Haematology, Westmead Hospital, Darcy Road, Westmead, New South Wales 2145, Australia. E-mail: mark_hertzberg@wmi.usyd.edu.au

Received 22 November 2005; Revised 6 February 2006; Accepted 11 February 2006; Published online 27 March 2006.

Abstract

Thirty-six patients with chronic B-lymphoproliferative disorders (B-LPD) underwent reduced-intensity allogeneic transplantation (RIT) from HLA-identical related donors. Diagnoses included follicular (n=17), mantle cell (n=9) and small lymphocytic lymphoma (n=2), and chronic lymphocytic leukaemia (n=8). Median age at transplant was 51 years (range, 30–66) and time from diagnosis was 3.4 years (range, 0.3–9.5). At transplant, 28% were in CR, 36% were in PR and 36% were chemorefractory. Conditioning therapy included fludarabine and either cyclophosphamide (n=27) or melphalan (n=9). Graft-versus-host disease (GVHD) prophylaxis consisted of cyclosporin (CsA)/methotrexate (n=21), CsA/mycophenolate mofetil (n=13) or CsA alone (n=2). Eight patients died owing to acute GVHD (n=3), infection in association with chronic GVHD (n=4) and intra-abdominal bleeding (n=1). Treatment-related mortality was 8% at day 100, and 17 and 20% at one and two years, respectively. The cumulative incidence of grade II–IV acute GVHD was 58%, whereas limited and extensive chronic GVHD occurred in 25 and 56%, respectively. No patient has relapsed or progressed. At a median follow-up of 48 months, overall survival probability is 80% (95% CI, 67–93%). We confirm that RIT in chronic B-LPD can result in high and durable CR rates but with significant incidences of acute and chronic GVHD.