UNRELATED ALLOGENEIC STEM CELL TRANSPLANTATION FOR ADULTPATIENTS WITH ACUTE LEUKEMIAS AND CHRONIC MYELOID LEUKEMIA –6 YEARS EXPERIENCE

Abstract

BACKGROUND Allogeneic stem cell transplantation is an efficient treatment modality for adult patientswith various leukemias. Due to lack of suitable family donors, stem cell transplantationwith unrelated HLA identical donors is increasingly performed. In the past, such transplantation was mostly used in treatment of chronic myeloid leukemia. Today it is rarelyused in this case because of the successful treatment with tyrosine kinase inhibitors, but it isbecoming more popular in the treatment of acute leukemias with unfavorable prognosticfactors. METHODS Between years 2002 and 2007 twenty-three patients with acute and chronic myeloidleukemias were transplanted. The survival curves were calculated using the Kaplan-Meiermethod and both the effect of the type of leukemia on the treatment outcome and thechange in indications after the introduction of new target drugs were estimated. RESULTS Estimated six years survival for patients with acute myeloblastic and chronic myeloicleukemia is around 60 %, which is similar to the rate for related allogeneic transplantations. However, for patients with acute lymphoblastic leukemia the survival rate is onlyaround 30 %. Unrelated transplantation for chronic myeloid leukemia is now only rarelyperformed in Slovenia. CONCLUSIONS Unrelated allogeneic stem cell transplantation is suitable mostly for acute leukemias withunfavorable risk factors. The success rate for treatment of acute myeloblastic leukemia issimilar to the one for related allogeneic transplantation. However, the situation in treatment of acute lymphoblastic leukemia is worse, probably due to a larger part of patientshaving the transplantation in the advanced stages of the disease