Pilot study of reduced-intensity conditioning followed by allogeneic stem cell transplantation from related and unrelated donors in patients with myelofibrosis.
A prospective pilot study was performed to evaluate the effect of reduced-intensity conditioning with busulphan (10 mg/kg), fludarabine (180 mg/qm) and anti-thymocyte globulin followed by allogeneic stem cell transplantation from related (n = 8) and unrelated donors (n = 13) in 21 patients with myelofibrosis. The median age of the patients was 53 years (range, 32-63). No primary graft failure occurred. The median time until leucocyte (>1.0 x 10(9)/l) and platelet (>20 x 10(9)/l) engraftment was 16 (range, 11-26) and 23 d (range, 9-139) respectively. Complete donor chimaerism on day 100 was seen in 20 patients (95%). Acute graft-versus-host disease (GvHD) grades II-IV and III/IV occurred in 48% and 19% of cases and 55% of the patients had chronic GvHD. Treatment-related mortality was 0% at day 100 and 16% [95% confidence interval (CI): 0-32%] at 1 year. Haematological response was seen in 100% and complete histopathological remission was observed in 75% of the patients and 25% of the patients showed partial histopathological remission with a continuing decline in the grade of fibrosis. After a median follow-up of 22 months (range, 4-59), the 3-year estimated overall and disease-free survival was 84% (95% CI: 67-100%).
Kröger
Nicolaus
N
Unit of Bone Marrow Transplantation, University Hospital Hamburg, D-20246 Hamburg, Germany. nkroeger@uke.uni-hamburg.de
Zabelina
Tatjana
T
Schieder
Heike
H
Panse
Jens
J
Ayuk
Francis
F
Stute
Norbert
N
Fehse
Natalja
N
Waschke
Olga
O
Fehse
Boris
B
Kvasnicka
Hans Michael
HM
Thiele
Jürgen
J
Zander
Axel
A
D000328:Adult; D000961:Antilymphocyte Serum / Q000008:administration & dosage; D001804:Blood Transfusion, Autologous; D002066:Busulfan / Q000008:administration & dosage; D018572:Disease-Free Survival; D005260:Female; D006086:Graft vs Host Disease / Q000517:prevention & control; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D017710:Lymphocyte Transfusion; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D055728:Primary Myelofibrosis / Q000401:mortality / Q000601:surgery*; D011446:Prospective Studies; D033581:Stem Cell Transplantation / Q000379:methods* / Q000401:mortality; D015996:Survival Rate; D018183:Transplantation Chimera; D019172:Transplantation Conditioning / Q000379:methods* / Q000401:mortality; D014740:Vidarabine / Q000008:administration & dosage / Q000031:analogs & derivatives*
D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents; D014740:Vidarabine; D002066:Busulfan; C024352:fludarabine