[Preliminary study of HLA haplotype matched and T-cell undepleted allogeneic bone marrow transplantation for treatment of leukemia].

OBJECTIVE: To explore the feasibility of allogeneic bone marrow transplantation (Allo-BMT) with graft from HLA haplotype matched related donor without T-cell depleted for the treatment of leukemia.
METHODS: Fifteen patients with leukemia received allo-BMT with grafts from HLA 2 or 3 antigen mismatched related donors. All patients were treated with standardized conditioning regimen consisting of high dose Ara-C, cyclophosphamide (CY) and total body irradiation (TBI). Donors were given G-CSF at 3 to 4 micrograms.kg-1.d-1 for seven days prior to marrow harvest. GVHD prophylaxis programme consisted of CsA, MTX, ATG and mycophenolate mofetial.
RESULTS: All patients established successful engraftment. The median days of granulocyte > 0.5 x 10(9)/L and platelet > 20 x 10(9)/L were 19(range 13-23) and 21 (range 16-32) days, respectively. Acute grade II-IV GVHD occurred in 5 of 15 patients (33.3%). Two of them were grade II gut aGVHD, 2 grade III gut aGVHD, and 1 grade IV gut and liver aGVHD. Chronic GVHDs were seen in 8 of 9 evaluable patients (88.9%) and none developed extensive cGVHD. The median follow-up duration was 395 (110-690) days. Six of fifteen patients died. Five of them died from transplantation related mortality and 1 from relapse. Nine patients were alive in a disease-free situation. Six of them survived more than one year.
CONCLUSION: The major histoincompatibility barriers in the haplotype matched related donor/recipient allo-BMT might be crossed by donor stimulated with G-CSF and combined GVHD prophylaxis program.