Intensification of the conditioning regimen by the addition of anthracyclines results in a higher incidence of sustained molecular remissions after allogeneic bone marrow transplantation for chronic myeloid leukaemia with marrow depleted of lymphocytes by counterflow centrifugation.

BACKGROUND: Relapse remains a significant problem in patients after bone marrow transplantation. The aim of the study was an effort to decrease the incidence of relapses in patients transplanted for chronic myeloid leukaemia (CML) by different conditioning regimens. METHODS AND RESULTS: 28 patients with CML who underwent allogeneic bone marrow transplantation with grafts depleted of 98% of lymphocytes were divided into two groups according to the conditioning regimen used. Patients in group 1 were conditioned without anthracyclines, and patients in group 2 were conditioned with the addition of anthracyclines. Bone marrow samples taken 6 and 12 months after BMT, and annually thereafter, were analyzed by polymerase chain reaction (PCR) for residual disease. Median time of bone marrow sampling and medium number of samples analyzed did not differ significantly between two groups of patients. In group 1, consisting of 11 patients, 40% of samples were negative, and in group 2 with 17 patients, PCR was negative in 79% of samples. It is evident that the addition of anthracyclines favourably influences posttransplantation development. CONCLUSIONS: The addition of anthracyclines to the conditioning regimen in recipients of grafts depleted of 98% of lymphocytes, significantly decreases the incidence of relapses even 4 years after BMT.