Bone marrow transplantation for chronic myeloid leukaemia using matched unrelated donors

Because the majority of patients with chronic myeloid leukaemia (CML) lack HLA identical siblings, attention has turned in recent years to the possibility of using suitably matched unrelated donors. Tissue typing methods must be refined to help identify the closest possible HLA phenotypic identity. For donor recipient matching the use of the mixed lymphocyte reaction is generally unhelpful and methods that predict for the incidence and severity of graft-versus-host disease, such as assay of cytotoxic T-lymphocyte precursors, may prove especially valuable. Preliminary results from several centres suggest that the probability of survival at two years for patients with CML allografted in chronic phase with matched unrelated donors is 35-40%.