Allogeneic peripheral blood stem cell transplantation for leukemia.
OBJECTIVE
To observe engraftment kinetics, the incidence and severity of graft-versus-host disease (GVHD), and clinical outcome on 40 recipients undergoing allogeneic peripheral blood stem cell transplantation (allo-PBSCT).


METHODS
From June 1997 to May 1999, forty leukemia patients with a median age of 35 years underwent allo-PBSCT. PBSC were mobilized with G-CSF at a dose of 5 micrograms/kg s.c. every 12 hours for 5 days. A median of 7.7 (2.0-16.8) x 10(6) CD34+ cells/kg was infused into the recipients. Busulfan-cyclophosphamide (BU-CY) was used as the conditioning regimen. All patients received cyclosporine A and either methotrexate (n = 34) or methylprednisolone (n = 6) for GVHD prophylaxis.


RESULTS
Engraftment of neutrophils and platelets was achieved at a median of 13 days (9-28 days) and 12 days (7-60 days) respectively. Patients receiving > or = 4 x 10(6) CD34+ cells/kg or given G-CSF post transplant had significantly accelerated neutrophil and platelet engraftment. Acute GVHD occurred in 17 of 40 patients (42.5%), with grade II-IV acute GVHD in 10 patients (25%). Chronic GVHD developed in 21 (9 extensive, 12 limited) out of 30 evaluable patients (21/30, 70%) with a median follow up of 380 days (180-900 days). Transplant related mortality was 17.5% and the relapse rate was 10%. The probability of leukemia free survival at 3 years was 72.5%.


CONCLUSIONS
Allo-PBSCT can provide rapid hematopoietic reconstitution without an increased incidence of acute GVHD, but may be associated with a high risk of chronic GVHD.
Zhu
K
K
Department of Hematology, First Affiliated Hospital, Medical College of Jinan University, Guangzhou 510632, China. ezengh1@zlcn.com
Xu
Y
Y
Wu
D
D
Xu
X
X
Huang
L
L
D000328:Adult; D002908:Chronic Disease; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D016130:Immunophenotyping; D007938:Leukemia / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012010:Red-Cell Aplasia, Pure / Q000209:etiology; D014184:Transplantation, Homologous