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


METHODS
40 leukemia patients with a median age of 35 years underwent allo-PBSCT from June 1997 to May 1999. PBSC were mobilized with G-CSF at a dose of 5 microg/kg S. C. every 12 hours for 5 days. A median of 7.7 (range 2.0 to 16.8) x 10(6) CD(34)(+) cells/kg was infused into the recipients. Busulfan (BU) and cyclophosphamide (CY) were used as 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 day + 13 (9 - 28) and day +12 (7 - 60) respectively. Patients receiving >or=4 x 10(6) CD(34)(+) cells/kg or given G-CSF post transplant had significantly accelerated neutrophil and platelet engraftment. Acute GVHD occurred in 17 of the 40 patients (42.5%), with grade II-IV acute GVHD in 10 patients (25.0%); chronic GVHD developed in 21 out of the 30 evaluable patients (70.0%) with a median follow up of 480 days (range 300 - 1,000). The transplant related mortality is 20.0% and the relapse rate is 10.0%. The probability of leukemia free survival at 3 years is 70.0%.


CONCLUSIONS
These results indicate that allo-PBSCT can provide rapid hematopoietic reconstitution without an increased incidence of acute GVHD, but may be associated with high risk of chronic GVHD.
Zhu
K
K
The First Affiliated Hospital,Medical College of Zhejiang University, Hangzhou 310009, China.
Xu
Y
Y
Wu
D
D
Xu
X
X
Huang
L
L
D000328:Adult; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D007938:Leukemia / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D014184:Transplantation, Homologous