Remarkably reduced transplant-related complications by dibromomannitol non-myeloablative conditioning before allogeneic bone marrow transplantation in chronic myeloid leukemia.
A non-myeloablative conditioning protocol containing dibromomannitol (DBM/cytosine arabinoside/cyclophosphamide) has been applied to 36 chronic myeloid leukemia (CML) patients followed by bone marrow transplantation (BMT) from sibling donors. Risk factors include: accelerated phase (10 patients), older age (17 patients over >40 years) and long interval between diagnosis and BMT (27 months on average). Severe mucositis did not occur. Venoocclusive liver disease was absent. Infectious complications were rare. Although grade II-IV acute graft-versus-host disease (GVHD) was present in 9 (25%) cases, there were only 2 serious (III-IV) ones. Chronic GVHD occurred in 25 (69%) cases, preceded by acute GVHD in 9 of the 25 affected patients. Early hematological relapse, 7-29 weeks after BMT, developed in 6 patients (17.6%). No relapse was noted in the completely chimeric patients, however molecular genetic residual disease was observed in 6 patients, in most of them after transient short-term mixed chimeric state. Overall actual survival rate is 83.3% for the 36 cases, and leukemia-free survival is 72.2% for the 34 engrafted patients.
Barta
A
A
National Institute of Hematology and Immunology, Budapest, Hungary.
Dénes
R
R
Masszi
T
T
Reményi
P
P
Bátai
A
A
Torbágyi
E
E
Sipos
A
A
Lengyel
L
L
Jakab
K
K
Gyódi
E
E
Réti
M
M
Földi
J
J
Páldi-Haris
P
P
Avalos
M
M
Pálóczi
K
K
Fekete
S
S
Török
J
J
Hoffer
I
I
Jakab
J
J
Váradi
G
G
Kelemen
E
E
Petrányi
G
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage / Q000592:standards / Q000633:toxicity; D016026:Bone Marrow Transplantation / Q000379:methods* / Q000592:standards; D002423:Cause of Death; D018572:Disease-Free Survival; D005260:Female; D006086:Graft vs Host Disease; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000150:complications / Q000188:drug therapy* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D008927:Mitobronitol / Q000008:administration & dosage* / Q000592:standards / Q000633:toxicity; D015996:Survival Rate; D018183:Transplantation Chimera; D019172:Transplantation Conditioning / Q000379:methods* / Q000592:standards; D014184:Transplantation, Homologous / Q000379:methods
D018906:Antineoplastic Agents, Alkylating; D008927:Mitobronitol