Abstract
Objective: To analyze long-term outcome in sixty leukemia patients received allogeneic hematopoietic stem cell transplantation (allo-HSCT) following busulfan and cyclophosphamide (BU-CY2) between 1994 and 2000. Methods: BU-CY2 was used as the conditioning regimen and allo-HSCT was performed for all patients. All the patients were followed-up until August 2001 or death. The leukemia-free survival, relapse and transplant-related mortality were discussed. Results: All 60 patients had sustained engraftment. Acute GVHD occurred in 22 out of 60 patients (36.7%), and the incidence of acute GVHD was 48% in the patients with CML, 30% in AML and 26.7% in ALL. 38 patients are still alive in continuous remission with a median follow-up of 30 months (range 12–84) and 22 patients have died. The main causes of death were acute GVHD in 3 patients, CMV-IP in 7 patients and relapse in 11 patients, the remaining one died of pulmonary infection. Among 11 patients who died of relapse, 8 patients with ALL relapsed in the early stage post transplant (8/15, 53.3%), relapse was observed in the remaining 3 patients with AML, and however, no relapse was observed in CML. The probability of disease-free survival at 3 years for CML. AML and ALL patients was 80%, 70% and 26.7%, respectively. Conclusion: This results suggests that BU-CY2 is an effective conditioning regimen in patients with AML and CML, resulting in a low relapse rate and high long-term survival rate, but not as effective in patients with ALL, with a higher incidence of relapse and therefore, not recommended for ALL patients.
Similar content being viewed by others
References
Glucksberg H, Stob R, Fefer A, et al. Clinical manifestations of graft-versus-host disease in human recipients of marrow from HLA-matched sibling donors [J]. Transplantation 1974; 18:295.
Shulman HM, Sullivan KM, Weiden PL, et al. Chronic graft-versus-host syndrome in man. A long-term clinicopathologic study of 20 Seattle patients [J]. Am J Med 1980; 69:204.
Atkinson K, Downs K, Dodds A, et al. Five year leukemia-free survival of 72% and 77% for early stage acute and chronic myeloid leukemia treated by HLA-identical sibling bone marrow transplantation [J]. Aust NZ J Med 1996; 26:54.
Copelan EA, Biggs JC, Szer J, et al. Allogeneic bone marrow transplantation for acute myelogenous leukemia, acute lymphocytic leukemia, and multiple myeloma following preparation with busulfan and cyclophosphamide (BU-CY2) [J]. Semin Oncol 1993; 20:33.
Von-Bueltzingsloewen A, Belanger R, Perreault C, et al. Allogeneic bone marrow transplantation following busulfan-cyclophosphamide with or without etoposide conditioning regimen for patients with acute lymphoblastic leukemia [J]. Br J Hematol 1993; 85:706.
Camara R, Granados E, Gill JJ, et al. Bone marrow transplantation in acute lymphoblastic leukemia (ALL): comparison of busulfan vs total body irradiation (TBI) as conditioning [J]. Bone Marrow Transplant 1998; 21(Suppl 1):S102.
Lalancette M, Michallet M, Szydlo R, et al. The importance of patient selection in non-myeloablative stem cell transplant (NMSCT) for acute and chronic leukemia, myelodysplastic syndrome, and myeloma [J]. Blood 2000; 96(Suppl 1): 199a.
Rezvni K, Lalancette M, Szydlo R, et al. Non-myeloablative stem cell transplant (NMSCT) for patients with advanced phase disease [J]. Blood 2000; 96(Suppl 1):479a.
Han P, McDonald T, Mangos H, et al. Immune escape mechanisms of acute lvmphoblastic leukemia (ALL) cell and a potential countering role for dendritic-like leukemia cells [J]. Blood 2000; 96(Suppl 1):721a.
Author information
Authors and Affiliations
Corresponding author
Additional information
Biography: ZHU Kang-er (1951-), male, master of medicine, professor, Department of Hematology, majors in clinical hematology.
Rights and permissions
About this article
Cite this article
Zhu, Ke., Zhong, J., Zhang, T. et al. A higher incidence of relapse for acute lymphocytic leukemia treated with allogeneic hematopoietic stem cell transplantation conditioned with BU-CY2 regimen. Chin J Cancer Res 15, 213–216 (2003). https://doi.org/10.1007/s11670-003-0029-8
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/s11670-003-0029-8