Uncertainty still exists with the effects of allogeneic PBSCT on the clinical outcomes of patients with hematological malignancies. Our aim was analyzed retrospectively the clinical outcomes of 483 patients who underwent an allo PBSCT in 9 Brazilian centers from May 1994 to February 2004. The analyses included patients with hematological malignancies who underwent PBSCT from HLA identical sibling donors. Median age was 34 (2-57), advanced disease was present in 58%, conditioning without irradiation was 85%; GVHD prophylaxis with MTX/CsA was 91%; CD34 ϩ median was 4.7 ϫ 10 6 /kg (0.51-71.6); the median follow-up for surviving patients was 797 days (8 -3420); median day for neutrophils and platelets engraftment was 15 and 14, respectively; cumulative incidence (CI) for 3 2 aGVHD was 38%; extensive cGVHD 63%; CI for transplant relate mortality (TRM) 59%; CI for relapse 37%; the estimates of OS and DFS at 9 ys are 33% and 42%, respectively. In univariate analyses the following factors were associated with better outcome: for neutrophils and platelets engraftment-CD34 ϩ cell dose Ͼ 2.8 ϫ 10 6 /kg, GVHD prophylaxis other than MTX/CsA, and sex match other than female donor for male recipient; aGVHD-age Ͻ43, and CD34 dose Ͼ4.7 ϫ 10 6 /kg; cGVHD-age Ͻ25 ys, sex match other than female donor for male recipient, advanced disease and CD3 ϩ dose Ͻ170 ϫ 10 6 /kg; OSearly disease; DFS-early disease, and CD34 ϩ dose Ͼ4.7 ϫ 10 6 /kg; relapse-age Ͼ25 ys, CD34 ϩ cell dose Ͼ2.8 ϫ 10 6 /kg, and early disease; TRM-early disease. All the results remained significant in multivariate analyses, but for CD34 ϩ dose and platelet engraftment; age and CD34 ϩ dose in aGVHD; age and CD3 ϩ in cGVHD, and age in relapse. In our experience, sex match, CD34 ϩ dose, GVHD prophylaxis may influence the engraftment, and sex match and disease phase the cGVHD. Furthermore, advanced disease had a negative impact on OS and TRM. CD34 ϩ higher dose and early disease were associated with better DFS and lower relapse.

We present the results of a prospective, randomised study comparing PBPC and BM focusing on engraftment, acute and chronic GVHD and survival. Forty patients with haematological malignancies received HLA-identical sibling BM (group A) or PBPC (group B). Evaluable patients were 19 (A) and 18 (B). Median age was 35 (17-56) in A and 29.5 (9-51) in B. Conditioning was mainly Bu-Cy2; GVHD prophylaxis was CSA-MTX. PBPC were harvested after 5 days of G-CSF 10 g/kg/day. Median days for an ANC Ͼ0.5 ؋ 10 9 /l was 18 (13-30) in A and 16 (11-25) in B (P = 0.10). Platelets Ͼ20 ؋ 10 9 /l occurred at ؉17 (10-40) in A and ؉12 (9-36) in B (P = 0.01). The probability of у2 grade a-GVHD was 19% (A) and 27% (B) (P = 0.53). The probability of all grade c-GVHD was 70% with BM. In spite of the small number of patients in group B (PBPC), our data suggest the great majority of them will have c-GVHD (P = 0.08); extensive disease was present in 50 and 100%, respectively (P = 0.05). The estimates of overall survival for A and B at 1000 days are 51 and 47%, respectively (P = 0.67); DFS at 1000 days are 52 and 58%, respectively (P = 0.50). PBPC resulted in faster platelet engraftment. The incidence of acute and chronic GVHD was similar in both groups, but the severity of c-GVHD was higher with PBPC. No differences in survival and DFS have been observed to date.

The management of chronic myeloid leukemia (CML) has changed radically since the introduction of imatinib therapy. The decision of whether to offer a patient a hematopoietic stem cell transplant (HSCT) must be based on the probability of success of the procedure. The aim of this retrospective analysis of 1,084 CML patients who received an allogeneic HSCT in 10 Brazilian Centers between February 1983 and March 2003 was to validate the EBMT risk score. The study population comprised 647 (60%) males and 437 (40%) females, with a median age of 32 years old (range 1 - 59); 898 (83%) were in chronic phase, 146 (13%) were in accelerated phase and 40 (4%) were in blast crisis; 151 (14%) were younger than 20 years old, 620 (57%) were between 20 and 40 and 313 (29%) were older than 40; 1,025 (94%) received an HLA fully matched sibling transplant and only 59 (6%) received an unrelated transplant. In 283 cases (26%) a male recipient received a graft from a female donor. The interval from diagno...

The management of chronic myeloid leukemia (CML) has changed radically since the introduction of imatinib therapy. The decision of whether to offer a patient a hematopoietic stem cell transplant (HSCT) must be based on the probability of success of the procedure. The aim of this retrospective analysis of 1,084 CML patients who received an allogeneic HSCT in 10 Brazilian Centers between February 1983 and March 2003 was to validate the EBMT risk score. The study population comprised 647 (60%) males and 437 (40%) females, with a median age of 32 years old (range 1 - 59); 898 (83%) were in chronic phase, 146 (13%) were in accelerated phase and 40 (4%) were in blast crisis; 151 (14%) were younger than 20 years old, 620 (57%) were between 20 and 40 and 313 (29%) were older than 40; 1,025 (94%) received an HLA fully matched sibling transplant and only 59 (6%) received an unrelated transplant. In 283 cases (26%) a male recipient received a graft from a female donor. The interval from diagno...