Pilot study of reduced-intensity conditioning followed by allogeneic stem cell transplantation from related and unrelated donors in patients with myelofibrosis

Br J Haematol. 2005 Mar;128(5):690-7. doi: 10.1111/j.1365-2141.2005.05373.x.

Abstract

A prospective pilot study was performed to evaluate the effect of reduced-intensity conditioning with busulphan (10 mg/kg), fludarabine (180 mg/qm) and anti-thymocyte globulin followed by allogeneic stem cell transplantation from related (n = 8) and unrelated donors (n = 13) in 21 patients with myelofibrosis. The median age of the patients was 53 years (range, 32-63). No primary graft failure occurred. The median time until leucocyte (>1.0 x 10(9)/l) and platelet (>20 x 10(9)/l) engraftment was 16 (range, 11-26) and 23 d (range, 9-139) respectively. Complete donor chimaerism on day 100 was seen in 20 patients (95%). Acute graft-versus-host disease (GvHD) grades II-IV and III/IV occurred in 48% and 19% of cases and 55% of the patients had chronic GvHD. Treatment-related mortality was 0% at day 100 and 16% [95% confidence interval (CI): 0-32%] at 1 year. Haematological response was seen in 100% and complete histopathological remission was observed in 75% of the patients and 25% of the patients showed partial histopathological remission with a continuing decline in the grade of fibrosis. After a median follow-up of 22 months (range, 4-59), the 3-year estimated overall and disease-free survival was 84% (95% CI: 67-100%).

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antilymphocyte Serum / administration & dosage
  • Blood Transfusion, Autologous*
  • Busulfan / administration & dosage
  • Disease-Free Survival
  • Female
  • Graft vs Host Disease / prevention & control
  • Humans
  • Immunosuppressive Agents / administration & dosage
  • Lymphocyte Transfusion*
  • Male
  • Middle Aged
  • Pilot Projects
  • Primary Myelofibrosis / mortality
  • Primary Myelofibrosis / surgery*
  • Prospective Studies
  • Stem Cell Transplantation / methods*
  • Stem Cell Transplantation / mortality
  • Survival Rate
  • Transplantation Chimera
  • Transplantation Conditioning / methods*
  • Transplantation Conditioning / mortality
  • Vidarabine / administration & dosage
  • Vidarabine / analogs & derivatives*

Substances

  • Antilymphocyte Serum
  • Immunosuppressive Agents
  • Vidarabine
  • Busulfan
  • fludarabine