Allogenictransplantation of the bone marrow after regimens of lowintensity conditioning in therapy of patients with hemoblastoses

Abstract


Aim. To investigate effectiveness of allogenic transplantation of the bone marrow (TBM) in the treatment
of hemoblastosis patients from a high risk group, the course of donor bone marrow retention, tolerance
and antitumor activity of this therapy.
Material and methods. 11 patients received TBM in low-intensity regimen in Hematological Research
Center in 1999-2001. All the patients were from a high risk group. Conditioning was based on the
combination of fludarabin with busulfan. The transplanted precursor cells were taken from the bone
marrow and/or peripheral donor blood. The retention was controlled by differential agglutination of
erythrocytes and amplification of hypervariable sites of DNA. Minimal residual disease was controlled
by standard cytogenetical tests, fluorescent in situ hybridization or reverse-transcriptase polymerase
chain reaction.
Results. All the patients tolerated pretransplantation conditioning well. By chimerism, signs of retention
of donor bone marrow on day +30 after TBM were observed in 9 patients of 11. Acute graft versus
host reaction developed in 5 patients. This reaction was treated conventionally with methylprednisone
and cyclosporin A, in 4 cases with a good effect. A complete remission persists in 5 patients. Mean follow-up
lasted for 241 days.
Conclusion. Thus, transplantation was successful in 50% patients with an unfavourable prognosis who
are still in a complete remission. This suggests efficacy of the above method of treatment.

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Copyright (c) 2020 Demidova I.A., Savchenko V.G., Olshanskaya Y.V., Poreshina L.P., Kutyina R.M., Surin V.L., Misyurin A.V., Domracheva E.V., Parovichnikova E.N.

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