title: Bone marrow transplantation for chronic myelogenous leukemia in chronic phase. Increased risk for relapse associated with T-cell depletion.
abstract: Data on 405 patients with chronic myelogenous leukemia who received bone marrow transplants in chronic phase were analyzed for factors predictive of outcome. The 4-year actuarial probability of relapse was 19% (95% confidence interval [CI], 12% to 28%) and of survival, 55%. In multivariate analyses the probability of relapse was higher for recipients of T-cell-depleted bone marrow compared with recipients of non-T-cell-depleted bone marrow (relative risk, 5.4; P less than 0.0001) and for patients who did not develop chronic graft-versus-host disease (95% CI, 50% to 60%) with patients who did (relative risk, 3.1; P less than 0.01). The probability of survival was lower for patients who developed moderate to severe acute graft-versus-host disease than for patients with no or mild acute graft-versus-host disease (relative risk, 3.7; P less than 0.0001), and in patients aged 20 or older than in younger patients (relative risk, 2.6; P less than 0.0002). Duration of disease before transplant was not associated with outcome. Bone marrow transplantation done in the chronic phase of chronic myelogenous leukemia offers some patients prolonged leukemia-free survival. The T-cell-depleted grafts are associated with an increased probability of relapse.
authors.affiliation: Department of Medicine, Medical College of Wisconsin, Milwaukee.
authors.forename: J M
authors.initials: JM
authors.lastname: Goldman
authors.forename: R P
authors.initials: RP
authors.lastname: Gale
authors.forename: M M
authors.initials: MM
authors.lastname: Horowitz
authors.forename: J C
authors.initials: JC
authors.lastname: Biggs
authors.forename: R E
authors.initials: RE
authors.lastname: Champlin
authors.forename: E
authors.initials: E
authors.lastname: Gluckman
authors.forename: R G
authors.initials: RG
authors.lastname: Hoffmann
authors.forename: S J
authors.initials: SJ
authors.lastname: Jacobsen
authors.forename: A M
authors.initials: AM
authors.lastname: Marmont
authors.forename: P B
authors.initials: PB
authors.lastname: McGlave
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001854:Bone Marrow Cells; D016026:Bone Marrow Transplantation; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000401:mortality / Q000517:prevention & control; D006801:Humans; D007223:Infant; D007951:Leukemia, Myeloid / Q000401:mortality / Q000628:therapy*; D008297:Male; D011336:Probability; D012008:Recurrence; D012307:Risk Factors; D013223:Statistics as Topic; D013601:T-Lymphocytes