Bone marrow transplantation for chronic granulocytic leukaemia

Abstract

Twenty-one patients with chronic granulocytic leukaemia underwent marrow transplantation. The donors were human-lymphocyte antigen-identical siblings in 19 cases. In the remaining 2 cases the donor was a parent in one and an identical twin in the other. The preparatory regimen included cyclophosphamide and 8.6 Gy total body irradiation given at either a dose of 0.1 Gy/min or 0.04 Gy/min. Five patients were in the accelerated phase of the disease, one was in remission following blast crisis, and the rest were all in the chronic phase. After chemotherapy and irradiation, all patients received bone marrow transplants. To date, nine patients are still alive, with a median survival of 64 days (range 28-683 days). One patient continued to have leukaemic cells and in another, the leukaemia recurred 18 months following transplantation. Interstitial pneumonitis was the cause of death of eight patients (38%). Graft-versus-host disease occurred in ten patients (47%).

Total Body Irradiation Conditioning Regimens in Stem Cell Transplantation

“…The development of HLA (human lymphocyte antigen) and MLC (mixed lymphocyte culture) assays allowed physicians to determine whether potential marrow donors were "histocompatible" (i.e., matched by HLA antigens and non-reactive to MLC cultures) and therefore less likely to develop graft-versus-host disease (GVHD) (Mahmoud et al 1985;Parr et al 1991;Petersdorf et al 1998). Initially, transplants were only performed between HLA-matched related donors, but, with Since the first successful bone marrow transplantation was performed at the University of Minnesota in 1960 (Gatti et al 1968), bone marrow and stem cell transplantation (SCT) has gained prominence as a therapy for a variety of diseases as outlined in Table 31.1.…”