1. ¹Department of Internal Medicine – Hematooncology, University Hospital Brno, Brno, Czech Republic
2. ²Department of Applied Mathematics, Faculty of Science, Masaryk University Brno, Brno, Czech Republic
3. ³Department of Pharmacology, 3rd Medical Faculty, Charles University, Prague, Czech Republic

Correspondence: Professor J Mayer, Department of Internal Medicine – Haematooncology, University Hospital Brno, Jihlavska 20, Brno 625 00, Czech Republic. E-mail: jmayer@fnbrno.cz

Received 27 February 2006; Revised 13 July 2006; Accepted 13 July 2006; Published online 28 August 2006.

Abstract

A reduced-intensity conditioning allogeneic stem cell transplantation was given to 19 patients (aged 15–59 years) in the first chronic phase and one patient in the accelerated phase with chronic myeloid leukemia (CML) after a regimen consisting of fludarabine (Flu), busulfan (Bu) and ATG Fresenius. The median follow-up was 27 months. Until day +100, no transplant-related mortality was recorded. The incidence of acute and chronic graft-versus-host disease (GvHD) was 55 and 75%, respectively. Two patients (10%) died from GvHD. Fourteen (70%) patients achieved molecular remission. Additional post-transplant intervention (donor lymphocyte infusion, imatinib) was necessary, however, in 10 patients (50% of the patients; non-achievement of stable molecular remission or later relapses). The total direct cost of the transplantation treatment for all of the patients came to 1 572 880 euro. If the patients had been treated with imatinib and followed-up with the same time period as they were following a transplantation, the direct cost of the imatinib treatment would have been 2 005 117 euro. The transplantation treatment appears to be less expensive after approximately 2 years of follow-up. Flu+Bu+ATG is a low-toxicity regimen for patients with CML. However, a close follow-up is necessary and about 50% of the patients require further therapeutic intervention.