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Conditioning Regimens

Non-myeloablative stem cell transplantation in patients with relapsed acute lymphoblastic leukemia: results of a multicenter study

Bone Marrow Transplantation volume 40, pages 535–539 (2007)Cite this article

Abstract

Using non-myeloablative conditioning, allogeneic hematopoietic stem cell transplantation (HSCT) was conducted in 43 ALL patients in a CR2. The median age of the patients was 19 years. Patients received oral busulfan 4 mg/kg/day for 2 days; i.v. cyclophosphamide 350 mg/m2/day for 3 days; and i.v. fludarabine 30 mg/m2/day for 3 days. Oral cyclosporin A 4 mg/kg was started and methotrexate 5 mg/m2 was delivered on days 1, 3, 5 and 11. The median CD34+ cell dose received was 5.0 × 106/kg. The medium time to achieve a granulocyte count above 0.5 × 109/l was 14 days. Thirteen patients were alive 30–1050 days after the HSCT. The 3-year overall survival rate was 30%. Ten patients (23%) developed acute GVHD, whereas eight patients (18.6%) developed chronic GVHD. Thirty patients died between days 47 and 1050 after the HSCT, most of them (70%) because of an ALL relapse. One hundred-day mortality was 15%, whereas transplant-related mortality was 21%. These results are inferior to those obtained using the same allografting method in other leukemias, probably as a consequence of poor susceptibility to the graft-versus-leukemia effect of the ALL cells beyond first remission as compared with other hematological malignancies.

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Authors and Affiliations

  1. Servicio de Hematología del Hospital Universitario de Monterrey, Monterrey, Nuevo León, México

    C H Gutierrez-Aguirre, D Gomez-Almaguer, O G Cantu-Rodríguez, O Gonzalez-Llano & J C Jaime-Perez

  2. Centro de Hematología y Medicina Interna de Puebla, Puebla, México

    S Herena-Perez, C A Manzano & G J Ruiz-Argüelles

  3. Laboratorios Clínicos de Puebla, Puebla, México

    R Estrada-Gomez, M L Gonzalez-Carrillo & G J Ruiz-Argüelles

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  1. C H Gutierrez-Aguirre
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  4. O Gonzalez-Llano
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Correspondence to G J Ruiz-Argüelles.

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Gutierrez-Aguirre, C., Gomez-Almaguer, D., Cantu-Rodríguez, O. et al. Non-myeloablative stem cell transplantation in patients with relapsed acute lymphoblastic leukemia: results of a multicenter study. Bone Marrow Transplant 40, 535–539 (2007). https://doi.org/10.1038/sj.bmt.1705769

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