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Marrow transplantation for patients in accelerated phase of chronic myeloid
leukemia
RA Clift, CD Buckner, ED Thomas, E Bryant, C Anasetti, WI Bensinger, R Bowden, HJ Deeg, KC Doney and LD Fisher
Fred Hutchinson Cancer Research Center, Seattle, WA.
The records were reviewed of 58 patients receiving transplants in Seattle
with unmanipulated marrow from HLA-identical siblings during the
accelerated phase (AP) of chronic myeloid leukemia. Variables examined for
association with survival and relapse included the interval from diagnosis
to transplant, the reasons for categorization as AP, age, regimen, and
cytomegalovirus serology. Four patients relapsed. The 4-year probabilities
of survival, relapse-free survival, nonrelapse mortality, and relapse were
0.49, 0.43, 0.51, and 0.12, respectively. After completion of the stepwise
multivariate analysis, age less than 38 years and categorization as AP
solely on the basis of chromosomal abnormalities emerged as being
independently significantly associated with improved survival. The 4-year
probability of survival for the 16 patients categorized as AP because of
chromosomal abnormalities and receiving transplant less than 1 year from
diagnosis was 0.74. The low probability of relapse in these patients
suggests that more aggressive preparative regimens are not indicated for
patients receiving transplants in AP because of the increased risk of
transplant-related mortality.
Volume 84,
Issue 12,
pp. 4368-4373,
12/15/1994
Copyright © 1994 by The American Society of Hematology
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