title: Allogeneic stem cell transplantation in chronic myeloid leukaemia--2 1/2 year experience.
abstract: OBJECTIVE
  To evaluate out come of allogeneic Stem Cell Transplantation (SCT) in chronic myeloid leukaemia (CMC) at Armed Forces Bone Marrow Transplant Centre, Rawalpindi from April 2002 to October 2004.
  
  
  METHODS
  Twenty-two patients with CML underwent allogeneic SCT from HLA matched siblings. Patients were divided into standard (n=14) and high-risk (n=8) groups. Patients were subjected to conditioning regimens consisting of Busulphan and Cyclophosphamide. Cyclosporin, Prednisolone and Methotrexate were given for GvHD prophylaxis. All donors were subjected to PBSC harvest after G-CSF therapy for five days. All received G-CSF from Day+5 until ANC >0.5 x 10(9)/l.
  
  
  RESULTS
  The median age of the patients was 29 years (range 7-53 years) with a male to female ratio of 6.3:1. Engraftment was achieved in all patients. Median time to achieve neutrophil (ANC 0.5 x 10(9)/l) and platelet (20 x 10(9)/l) recovery was 13 days and 12 days respectively. Median stay in hospital was 18 days. Acute GvHD (Grade-II-IV) was observed in eleven patients (50%) while chronic GvHD was seen in four patients (18%). One patient relapsed 8 months post transplant. Two patients (9%) developed Veno-occlusive disease (VOD) liver. One patient had haemorrhagic cystitis. Four patients (18%) had post transplant infectious complications, which included pseudomonas septicemia, aspergillosis, tuberculous pleural effusion and herpes zoster. Overall mortality was 22.7% (n=5). The major causes of mortality were VOD liver, GvHD grade IV, Pseudomonas septicaemia and aspergillosis. Overall survival was 77.2% (n=17) and disease free survival was (n=16) 72.7%. Follow up ranges were from 23 to 828 days (median 212 days).
  
  
  CONCLUSIONS
  The preliminary results of SCT in this small series of patients with CML are very encouraging. To improve the long-term survival it is imperative that patients are transplanted early after diagnosis and conditioning regimens are selected carefully.
authors.affiliation: Armed Forces Bone Marrow Transplant Centre, Rawalpindi, Pakistan.
authors.forename: KhalilUllah
authors.initials: K
authors.lastname: Hashmi
authors.forename: Badshah
authors.initials: B
authors.lastname: Khan
authors.forename: Parvez
authors.initials: P
authors.lastname: Ahmed
authors.forename: Iftikhar
authors.initials: I
authors.lastname: Hussain
authors.forename: Shahid
authors.initials: S
authors.lastname: Raza
authors.forename: Hamid
authors.initials: H
authors.lastname: Iqbal
authors.forename: Hamid Saeed
authors.initials: HS
authors.lastname: Malik
authors.forename: Muhammad Khalid
authors.initials: MK
authors.lastname: Kamal
authors.forename: Masood
authors.initials: M
authors.lastname: Anwar
mesh_terms: D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation; D002648:Child; D002675:Child, Preschool; D005260:Female; D006772:Hospitals, Military; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018570:Risk Assessment; D035781:Siblings; D016019:Survival Analysis; D014184:Transplantation, Homologous; D016896:Treatment Outcome