Abstract
Nine patients with chronic myelogenous leukemia (CML) including 6 in chronic phase, 1 in accelerated phase and 2 in blastic crisis were treated with high-dose chemoradiotherapy followed by bone marrow transplantation from 8 HLA-identical and 1 HLA-mismatched sibling donors. The patients ranged from 8 to 33 yr in age. Six patients who had not previously undergone splenetomy recieved radiotherapy to the spleen. To prevent acute GVHD, either cyclosporin-A or methotrexate was given to all patients. At the time of analysis (May, 1986), 5 transplant patients in chronic phase are alive after a median follow-up of 11 months (range 5 to 19). Other patients were died of complications. The complications were apparently more frequent in accelerated phase and blastic crisis than in chronic phase. The degree of acute GVHD was not so different between those in chronic phase and in more advanced disease (accelerated phase and blastic crisis). These observations suggest that the probability of cure is highest if transplantation is performed while the patient remains in the chronic phase.
And then, we report one typical case with CML in chronic phase who received MCNU, which could rapidly reduce white cell count and increase % of lymphocytes, and so that could be tissue-typed early and easily. Therefore, MCNU can be used for efficient reduction of white cell count prior to tissue typing of patients with CML.
