Late mortality and relapse following BuCy2 and HLA-identical sibling marrow transplantation for chronic myelogenous leukemia

Biol Blood Marrow Transplant. 2009 Jul;15(7):851-5. doi: 10.1016/j.bbmt.2009.03.013.

Abstract

Allogeneic hematopoietic stem cell transplantation (HSCT) is the only known curative therapy for chronic myelogenous leukemia (CML). Failure, because of relapse or nonrelapse mortality (NRM), generally occurs within 3 years of transplantation, but large studies with long-term follow-up are limited. We present mature results in 335 patients with CML who underwent allogeneic bone marrow transplantation (BMT) from HLA-identical siblings following busulfan and cyclophosphamide (BU/Cy2). Two hundred twenty-nine were in chronic phase (CP) and 106 in accelerated or blastic phase at transplantation. Median follow-up exceeded 14 years. The estimated probability of 18-year leukemia-free survival (LFS) for CP patients was 55.6% and for those beyond CP, 10.5%. Of 182 patients who survived leukemia-free at 3 years, the estimated probability of LFS at 18 years was 61.9%. Late relapse (P = .039) and late NRM (P = .008) occurred at higher rates in patients beyond CP at transplantation. There was no plateau in LFS.

Publication types

  • Clinical Trial
  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
  • Bone Marrow Transplantation*
  • Busulfan / administration & dosage
  • Cyclophosphamide / administration & dosage
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Histocompatibility Testing
  • Humans
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / mortality*
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / therapy*
  • Male
  • Middle Aged
  • Recurrence
  • Siblings*
  • Survival Rate
  • Transplantation, Homologous

Substances

  • Cyclophosphamide
  • Busulfan

Supplementary concepts

  • BUCY-2 protocol