[Allogeneic peripheral blood stem cell transplantation for treatment of leukemia]

To observe engraftment kinetics, incidence and severity of graft-versus-host disease (GVHD) and clinical outcome in 40 recipients undergoing allogeneic peripheral blood stem cell transplantation (allo-PBSCT).

40 leukemia patients with a median age of 35 years underwent allo-PBSCT from June 1997 to May 1999. PBSC were mobilized with G-CSF at a dose of 5 microg/kg S. C. every 12 hours for 5 days. A median of 7.7 (range 2.0 to 16.8) x 10(6) CD(34)(+) cells/kg was infused into the recipients. Busulfan (BU) and cyclophosphamide (CY) were used as conditioning regimen. All patients received cyclosporine A and either methotrexate (n = 34) or methylprednisolone (n = 6) for GVHD prophylaxis.

Engraftment of neutrophils and platelets was achieved at a median of day + 13 (9 - 28) and day +12 (7 - 60) respectively. Patients receiving >or=4 x 10(6) CD(34)(+) cells/kg or given G-CSF post transplant had significantly accelerated neutrophil and platelet engraftment. Acute GVHD occurred in 17 of the 40 patients (42.5%), with grade II-IV acute GVHD in 10 patients (25.0%); chronic GVHD developed in 21 out of the 30 evaluable patients (70.0%) with a median follow up of 480 days (range 300 - 1,000). The transplant related mortality is 20.0% and the relapse rate is 10.0%. The probability of leukemia free survival at 3 years is 70.0%.

These results indicate that allo-PBSCT can provide rapid hematopoietic reconstitution without an increased incidence of acute GVHD, but may be associated with high risk of chronic GVHD.