Outcome And Prognosis In Chronic Myeloid Leukemia With Sibling Allogeneic Peripheral Blood Stem Cell Transplantation

Objective:To evaluate the outcome and prognosis in chronic myeloid leukemia(CML)with sibling allogeneic peripheral blood stem cell transplantation(allo-PBSCT).Methods:From July 2001 to August 2007,35 patients with chronic myeloid leukemia(CML)received sibling allo-PBSCT in our hospital.Among them,29 patients were male and 6 patients were female.The median age was 33(15～49) years old.Twenty-nine patients were in choronic phase₁(CP₁),3 patients were in accelerate phase(AP),2 patients were in blast phase(BP)and one patient was in choronic phase₂(CP₂).Thirty patients were HLA matched sibling donors and 5 patients were HLA single antigen mismatched sibling donors.Thirty-three patients received a conditioning regimen based on busulfan(BU)and cyclophosphamide(CY)and 2 patients received a conditioning regimen based on total body irradiation(TBI)and cyclophosphamide(CY).Graft-versus-host disease(GVHD)prophylaxis consisted of cyclosporine(CsA),methothexate (MTX)and mycophenolate mofetil(MMF).Results:With a median follow up of 35(3-75)months,25(71.4%)patients survived(with disease free).The estimated overall survival(OS)and disease free survival(DFS)at 3 years were both 71.4%.The estimated DFS at 3 years in standard risk patients and high risk patients were 82.8%and 16.7%respectively. The cumulative rate of relapse at 3 years in standard risk patients and high risk patients were estimated at 10.3%and 50%respectively.Acute graft-versus-host disease(aGVHD)occurred in 6(17.1%)patients(â… -â…¡grade),chronic graft-versus-host disease(cGVHD)occurred in 15(42.9%)patients.Relapse occurred in 6 patients(17.1%).According to the COX Model,Disease stage, Interval from diagnosis to transplantation and EBMT risk score might affected DFS.Conclusion:Patients transplanted in CML first chronic phase,Interval from diagnosis to transplantation≤12 months and EBMT risk score≤2 were factors associated with improved DFS.CsA,MTX and MMF as graft-versus-host disease prophylaxis proved to be effective in controlling the severity of aGVHD.