[A new radiation-free conditioning in bone marrow transplantation and dibromo-mannitol therapy in chronic myeloid leukemia].
A new, radiation-free, conditioning protocol, containing the original Hungarian mitobronitol (DBM) (DBM/ cytosine arabinoside/cyclosphosphamide) has been applied to 36 chronic myeloid leukemia (CML) patients followed by bone marrow transplantation (BMT) from HLA identical sibling donors between 1990-1997. In spite of some prognostically disadvantageous factors (half of them were above 40 years, 10 out of 36 patients were in accelerated phase, the disease history was longer than 2 years in average) the overall survival (30/36) and the leukemia free survival rate (26/36) were in accordance with the best international results. Transplantation-related toxicity was remarkably reduced in comparison to bone marrow transplantation performed by total body irradiation/cyclophosphamide (TBI/Cy) or busulphan/cyclophosphamide (Bu/Cy) conditioning protocols. Acute graft versus host disease was present in lower percentage (9/36) and the number of serious cases was only 2/36. Chronic GVH disease, generally known to be associated with antileukemic effect (GVL), occurred in 25 of cases. Early haematological relapse among the 34 patients with functioning graft occurred in 6 patients which rate is slightly higher than reported after TBI/Cy or Bu/Cy conditioning treatment. There was no relapse among patients transplanted within one year post-diagnosis and patients having CML with accelerated phase. The leukemia free post-transplant period was in association with the chronic GVH disease and full chimeric state.
Kelemen
E
E
Országos Hematológiai és Immunológiai Intézet Budapest.
Dénes
R
R
Barta
A
A
Masszi
T
T
Reményi
P
P
Pálóczi
K
K
Bátai
A
A
Torbágyo
E
E
Sipos
A
A
Lengyel
L
L
Jakab
K
K
Gyódi
E
E
Réti
M
M
Földi
J
J
Páldi-Haris
P
P
Manuel
A
A
Fekete
S
S
Török
J
J
Hoffer
I
I
Jakab
J
J
Váradi
G
G
Petrányi
G
G
D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation; D002985:Clinical Protocols; D005260:Female; D006087:Graft vs Host Reaction / Q000187:drug effects; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D008927:Mitobronitol / Q000627:therapeutic use*
D008927:Mitobronitol