Bone marrow transplantation for chronic granulocytic leukaemia

Area of Science:

• Hematology
• Oncology
• Immunology

Background:

• Chronic granulocytic leukaemia (CGL) is a myeloproliferative neoplasm.
• Marrow transplantation is a potential curative therapy for CGL.
• Identifying optimal conditioning regimens and managing complications are crucial for successful transplantation.

Purpose of the Study:

• To evaluate the efficacy and safety of marrow transplantation in patients with chronic granulocytic leukaemia.
• To assess the impact of conditioning regimens, including cyclophosphamide and total body irradiation, on transplant outcomes.
• To analyze the incidence of complications such as interstitial pneumonitis and graft-versus-host disease.

Main Methods:

• Twenty-one CGL patients underwent allogeneic or syngeneic marrow transplantation.
• Conditioning involved cyclophosphamide and 8.6 Gy total body irradiation at different dose rates.
• Patient disease phase (chronic, accelerated, or blast crisis remission) was recorded.

Main Results:

• Nine out of 21 patients survived with a median survival of 64 days.
• Eight patients (38%) died from interstitial pneumonitis.
• Ten patients (47%) experienced graft-versus-host disease.
• Leukaemic relapse occurred in two patients.

Conclusions:

• Marrow transplantation for CGL demonstrated significant toxicity and limited long-term survival in this cohort.
• Interstitial pneumonitis and graft-versus-host disease represent major challenges post-transplantation.
• Further optimization of conditioning regimens and supportive care is warranted to improve outcomes.