1. ¹Servicio de Hematología del Hospital Universitario de Monterrey, Monterrey, Nuevo León, México
2. ²Centro de Hematología y Medicina Interna de Puebla, Puebla, México
3. ³Laboratorios Clínicos de Puebla, Puebla, México

Correspondence: Dr GJ Ruiz-Argüelles, Centro de Hematología y Medicina Interna de Puebla, Clinica Ruiz de Puebla, 8B Sur 3710, 72530 Puebla, Puebla, México. E-mail: gruiz1@clinicaruiz.com

Received 11 January 2007; Revised 30 May 2007; Accepted 4 June 2007; Published online 9 July 2007.

Abstract

Using non-myeloablative conditioning, allogeneic hematopoietic stem cell transplantation (HSCT) was conducted in 43 ALL patients in a CR2. The median age of the patients was 19 years. Patients received oral busulfan 4 mg/kg/day for 2 days; i.v. cyclophosphamide 350 mg/m²/day for 3 days; and i.v. fludarabine 30 mg/m²/day for 3 days. Oral cyclosporin A 4 mg/kg was started and methotrexate 5 mg/m² was delivered on days 1, 3, 5 and 11. The median CD34+ cell dose received was 5.0 10⁶/kg. The medium time to achieve a granulocyte count above 0.5 10⁹/l was 14 days. Thirteen patients were alive 30–1050 days after the HSCT. The 3-year overall survival rate was 30%. Ten patients (23%) developed acute GVHD, whereas eight patients (18.6%) developed chronic GVHD. Thirty patients died between days 47 and 1050 after the HSCT, most of them (70%) because of an ALL relapse. One hundred-day mortality was 15%, whereas transplant-related mortality was 21%. These results are inferior to those obtained using the same allografting method in other leukemias, probably as a consequence of poor susceptibility to the graft-versus-leukemia effect of the ALL cells beyond first remission as compared with other hematological malignancies.