Patient characteristics
Median age | 41 (range, 12-63) |
Diagnosis | |
Chronic myeloid leukemia | 55 (52%) |
Acute myeloid leukemia | 19 (18%) |
Acute lymphoid leukemia | 9 (9%) |
Acute biphenotypic leukemia | 1 (1%) |
Myelodysplasia | 12 (11%) |
Myelofibrosis | 2 (2%) |
Essential thrombocythemia | 1 (1%) |
Multiple myeloma | 2 (2%) |
Non-Hodgkin lymphoma | 3 (3%) |
Hodgkin disease | 1 (1%) |
Donor compatibility | |
HLA-identical siblings | 54 (51%) |
HLA-A–, -B– and -DR–matched unrelated volunteers | 38 (36%) |
HLA-mismatched relatives | 6 (6%) |
HLA-mismatched unrelated volunteers | 7 (7%) |
Pretransplant splenectomy | 3 (3%) |
Number of previous hematopoietic cell transplants | |
0 | 100 (95%) |
1 | 5 (5%) |
Conditioning* | |
Busulfan + cyclophosphamide | 42 (40%) |
Total body irradiation + cyclophosphamide | 54 (52%) |
Other | 9 (9%) |
Graft | |
T-cell replete marrow | 105 (100%) |
GVHD prophylaxis | |
Cyclosporine (daily until d 180) + methotrexate (d 1, 3, 6, 11) | 92 (88%) |
Other | 13 (12%) |
Graft failure | 0 (0%) |
Acute GVHD grade† | |
0 | 10 (10%) |
1 | 4 (4%) |
2 | 77 (73%) |
3 | 14 (13%) |
4 | 0 (0%) |
Chimerism status on day 80 | |
Full (more than 90% marrow cells of donor origin) | 104 (99%) |
Mixed (88% marrow cells of donor origin) | 1 (1%) |
Relapse before day 365 | 8 (8%) |
Nonrelapse death before day 365 | 11 (10%) |
Clinical extensive chronic GVHD diagnosed before day 365‡ | 64 (61%) |
Median age | 41 (range, 12-63) |
Diagnosis | |
Chronic myeloid leukemia | 55 (52%) |
Acute myeloid leukemia | 19 (18%) |
Acute lymphoid leukemia | 9 (9%) |
Acute biphenotypic leukemia | 1 (1%) |
Myelodysplasia | 12 (11%) |
Myelofibrosis | 2 (2%) |
Essential thrombocythemia | 1 (1%) |
Multiple myeloma | 2 (2%) |
Non-Hodgkin lymphoma | 3 (3%) |
Hodgkin disease | 1 (1%) |
Donor compatibility | |
HLA-identical siblings | 54 (51%) |
HLA-A–, -B– and -DR–matched unrelated volunteers | 38 (36%) |
HLA-mismatched relatives | 6 (6%) |
HLA-mismatched unrelated volunteers | 7 (7%) |
Pretransplant splenectomy | 3 (3%) |
Number of previous hematopoietic cell transplants | |
0 | 100 (95%) |
1 | 5 (5%) |
Conditioning* | |
Busulfan + cyclophosphamide | 42 (40%) |
Total body irradiation + cyclophosphamide | 54 (52%) |
Other | 9 (9%) |
Graft | |
T-cell replete marrow | 105 (100%) |
GVHD prophylaxis | |
Cyclosporine (daily until d 180) + methotrexate (d 1, 3, 6, 11) | 92 (88%) |
Other | 13 (12%) |
Graft failure | 0 (0%) |
Acute GVHD grade† | |
0 | 10 (10%) |
1 | 4 (4%) |
2 | 77 (73%) |
3 | 14 (13%) |
4 | 0 (0%) |
Chimerism status on day 80 | |
Full (more than 90% marrow cells of donor origin) | 104 (99%) |
Mixed (88% marrow cells of donor origin) | 1 (1%) |
Relapse before day 365 | 8 (8%) |
Nonrelapse death before day 365 | 11 (10%) |
Clinical extensive chronic GVHD diagnosed before day 365‡ | 64 (61%) |
HLA indicates human lymphocyte antigens; GVHD, graft-versus-host disease.
Usual dosing: busulfan, 16 mg/kg, cyclophosphamide, 120 mg/kg, total body irradiation, 12.0-13.2 Gy.
Treated usually with prednisone 2 mg/kg for 10 to 14 days with subsequent taper over 50 days.
Treated usually with prednisone (0.5-1.0 mg/kg every other day plus cyclosporine (approximately 6 mg/kg orally every other day) for at least 9 months.