Search

Background: Between May 1987 and January 2001 thirty-six patients with MDS (RA: n=2, RAEB: n=5, RAEBIT: n=8, CMML: n=4) and sAML (n=17) with a median age of 39 (range, 18-68) years, twenty-four males and twelve females, underwent allogeneic transplantation at the University Hospital of Vienna. Methods: Ten patients received peripheral blood stem cells ant twenty-six marrow grafts. Donors were siblings (n=27) and unrelated persons (n=9). Twenty-two patients had received chemotherapy before SCT. At the time of transplantation, there were fourteen patients in complete remission and twenty-two with active disease (patial remission: n=1, primary refractory: n=7, untreated: n=14). For conditioning the majority of patients received total body irradiation with cyclophosphamide (CY). Four patients, undergoing dose-reduced allogeneic SCT received Fludarabine and TBI of 2 Gy. In the majority graft-versus-hose disease prophylaxis consisted of cyclosporine (CSA) with methotrexate. Results: All patients had rapid und sustained hematological reconstitution. Twelve patients (33%) died of transplant related causes. Twelve patients (33%) experienced relapse after SCT. At a median follow-up of 44 (range, 2-144) months 15/36 (42%) patients are alive and twelve of the are in continuous complete remission. Results stratified in accordance to the International Prognostic Scoring System will be presented. Conclusions: Treatment-related morbidity and mortality are high. Currently, allogeneic SCT with dose reduced conditioning is under clinical investigation and would allow to give a curative therapy without substantially increase risk to treatment-related morbidity and mortality in patients with advanced disease who received intensive previous therapy. [ABSTRACT FROM AUTHOR]