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  • Original Article
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Chronic Myeloid Leukaemia

Fate of chronic myeloid leukemia patients treated with allogeneic bone marrow transplantation or chemotherapy and/or interferon at a single center: long-term results

Bone Marrow Transplantation volume 29, pages 1–8 (2002)Cite this article

Abstract

From April 1981 to February 2000, 105 patients with chronic myeloid leukemia (CML) underwent BMT from HLA-identical related donors at a single center. Eighty-eight patients were in chronic phase (CP), 11 patients in accelerated phase and six patients in blast crisis. Ten of these patients received a second BMT (BMT2). Comparison of BMT in CP with chemotherapy and/or α-IFN (n = 70) was also made. Patients were given cyclophosphamide (CY) and single-dose TBI (CYTBI, n = 38) or busulfan (BU) and CY (BUCY, n = 67). Overall 54 patients are alive and 52 of them are disease-free with a median follow-up of 11.3 (range 1.1–19.4) years. Ten-year disease-free survival (DFS) in CP patients was better after BUCY, 61% (95% CI, 47–68%) than after CYTBI, 41% (95% CI, 23–61%) (P = 0.07). For 88 patients who received a transplant in CP, results were significantly improved when BMT was performed within 1 year after diagnosis (P = 0.02) or at an age ⩽25 years old (P = 0.01). Ten-year survival in patients who received BMT in CP was better than in patients treated with chemotherapy (56% vs 10%; P = 0.0001) or α-IFN-based treatment (33%; P = 0.09) with survival curves crossing at 4.2 years and at 4 years, respectively. The probability of DFS after BMT2 was 60% (95% CI, 26–87%). CP patients who received BMT after CYTBI had a higher probability of relapse and transplant-related mortality than patients receiving BUCY (53% and 58% vs 9% and 34%; P = 0.002 and P = 0.08, respectively). All but six patients are currently on no medication and have resumed all activities without any limitation. These long-term results confirm that allogeneic BMT is the only curative approach for CML patients and should be offered to all patients with a suitable donor as soon after diagnosis as possible.

Bone Marrow Transplantation (2002) 29, 1–8. doi:10.1038/sj.bmt.1703323

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Acknowledgements

The authors thank Ms Jan Mohabull for technical assistance and all the members of our BMT Team for their exemplary care of these patients. This work has been supported by the Berloni Foundation against Thalassemia, and by the Italian Association against Leukemia, Pesaro.

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  1. Unità Operativa di Ematologia e Centro Trapianti di Midollo Osseo di Muraglia, Azienda Ospedaliera S, Salvatore di Pesaro, Italy

    D Gaziev, M Galimberti, P Polchi, E Angelucci, C Giardini, D Baronciani, M Andreani, B Persini, B Erer, P Sodani, M Manna, G Nicolini, G Visani & G Lucarelli

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  2. M Galimberti
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Gaziev, D., Galimberti, M., Polchi, P. et al. Fate of chronic myeloid leukemia patients treated with allogeneic bone marrow transplantation or chemotherapy and/or interferon at a single center: long-term results. Bone Marrow Transplant 29, 1–8 (2002). https://doi.org/10.1038/sj.bmt.1703323

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