Long-term follow-up of allogeneic bone marrow transplantation after reduced-intensity conditioning in patients with chronic myelogenous leukemia in the chronic phase.

Shinichiro Okamoto, Reiko Watanabe, Satoshi Takahashi, Takehiko Mori, Tohru Izeki, Hitomi Nagayama, Akaru Ishida, Nobuyuki Takayama, Kenji Yokoyama, Arinobu Tojo, Shigetaka Asano, Yasuo Ikeda

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Abstract

Although allogeneic transplantation is a curative therapy for chronic myelogenous leukemia (CML), treatment-related mortality is still a major cause of death after transplantation, especially in older patients. We investigated the safety and efficacy of reduced-intensity conditioning consisting of low-dose (600 cGy) total body irradiation and cytosine arabinoside (1 g/m2) together with a continuous infusion of granulocyte colony-stimulating factor and cyclophosphamide (120 mg/kg) in patients with CML in the chronic phase. Fractionated splenic irradiation (5 Gy) was also administered as part of the conditioning treatment. Eight patients older than 40 years underwent allogeneic bone marrow transplantation from an HLA-matched sibling following this conditioning. Regimen-related toxicities (equal to or greater than grade III) were not observed. Rapid restoration of 100% donor chimerism was confirmed by fluorescence in situ hybridization methods in 5 sex-mismatched transplant recipients. One patient died from severe acute graft-versus-host disease and another from Pneumocystis carinii pneumonia early in the course of transplantation. A sustained engraftment was achieved in 5 long-term survivors; in 1 case, the graft was rejected but the Philadelphia chromosome and BCR/ABL-negative autologous hemopoiesis were restored. After a minimum follow-up period of 60 months, 6 patients, including the patient with restored autologous hemopoiesis, were still alive and in remission with 100% donor chimerism. Six years after the transplantation, 1 patient experienced a cytogenetic relapse, which was successfully treated with donor lymphocyte infusions. In summary, this reduced-intensity conditioning resulted in a cure with markedly reduced regimen-related toxicities in this relatively older cohort of patients with CML.

Original languageEnglish
Pages (from-to)493-498
Number of pages6
JournalInternational Journal of Hematology
Volume75
Issue number5
Publication statusPublished - 2002 Jun

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Leukemia, Myeloid, Chronic Phase
Homologous Transplantation
Bone Marrow Transplantation
Chimerism
Transplantation
Tissue Donors
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Philadelphia Chromosome
Pneumocystis Pneumonia
Conditioning (Psychology)
Whole-Body Irradiation
Cytarabine
Graft vs Host Disease
Granulocyte Colony-Stimulating Factor
Fluorescence In Situ Hybridization
Cytogenetics
Cyclophosphamide
Survivors
Siblings
Cause of Death

ASJC Scopus subject areas

  • Hematology

Cite this

Long-term follow-up of allogeneic bone marrow transplantation after reduced-intensity conditioning in patients with chronic myelogenous leukemia in the chronic phase. / Okamoto, Shinichiro; Watanabe, Reiko; Takahashi, Satoshi; Mori, Takehiko; Izeki, Tohru; Nagayama, Hitomi; Ishida, Akaru; Takayama, Nobuyuki; Yokoyama, Kenji; Tojo, Arinobu; Asano, Shigetaka; Ikeda, Yasuo.

In: International Journal of Hematology, Vol. 75, No. 5, 06.2002, p. 493-498.

Research output: Contribution to journalArticle

Okamoto, S, Watanabe, R, Takahashi, S, Mori, T, Izeki, T, Nagayama, H, Ishida, A, Takayama, N, Yokoyama, K, Tojo, A, Asano, S & Ikeda, Y 2002, 'Long-term follow-up of allogeneic bone marrow transplantation after reduced-intensity conditioning in patients with chronic myelogenous leukemia in the chronic phase.', International Journal of Hematology, vol. 75, no. 5, pp. 493-498.
Okamoto, Shinichiro ; Watanabe, Reiko ; Takahashi, Satoshi ; Mori, Takehiko ; Izeki, Tohru ; Nagayama, Hitomi ; Ishida, Akaru ; Takayama, Nobuyuki ; Yokoyama, Kenji ; Tojo, Arinobu ; Asano, Shigetaka ; Ikeda, Yasuo. / Long-term follow-up of allogeneic bone marrow transplantation after reduced-intensity conditioning in patients with chronic myelogenous leukemia in the chronic phase. In: International Journal of Hematology. 2002 ; Vol. 75, No. 5. pp. 493-498.
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AU - Mori, Takehiko

AU - Izeki, Tohru

AU - Nagayama, Hitomi

AU - Ishida, Akaru

AU - Takayama, Nobuyuki

AU - Yokoyama, Kenji

AU - Tojo, Arinobu

AU - Asano, Shigetaka

AU - Ikeda, Yasuo

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