Between January 1989 and July 1995 the search for an unrelated donor (UD) was started for 379 consecutive Italian @entity1 with Philadelphia positive (Ph+) @entity1860 ( @entity1860 ). 89 (23%) were transplanted. The overall probability of transplant before and after December 1991 was 16% and 49%, respectively (P=0.0001), and average interval between search activation and graft was 23 months and 13 months, respectively (P=0.0001). Disease-free survival (DFS) following 60 consecutive transplants performed before February 1996 was 41.5% at 48 months and was 64% for @entity1 grafted after January 1993. In univariate analysis, five variables had a favourable effect on DFS: year of bone marrow transplantation (BMT) after 1993 (P=0.0002), @entity1533 donor/recipient (D/R) match (P=0.0006), total body irradiation (TBI) containing regimen (P=0.0006), @entity2132 ( @entity2132 ) prophylaxis including 'early' cyclosporin before the transplant, and a marrow cell dose > 3 x 10(8)/kg of recipient body weight (P=0.04). Multivariate analysis confirmed that HLA identity (P=0.006), TBI-containing regimen (P=0.0001) and 'early cyclosporin' (P=0.04) were associated with higher DFS. Transplant-related mortality (TRM) was 67% in @entity1 grafted before January 1993 and 30% in @entity1 grafted subsequently (P=0.002). Multivariate analysis confirmed @entity1533 identity (P=0.03) and TBI-containing regimen (P=0.0005) to be independent factors predictive of low TRM. This suggests that the outcome of @entity1 transplanted from an @entity1533 matched donor, after a TBI-containing preparative regimen, is similar to results recently reported in @entity1 transplanted from geno-identical siblings. These results indicate that the search should be initiated at diagnosis for @entity1 < 45 years of age and UD BMT should be considered early in the disease course for those with an available @entity1533 -matched unrelated donor.

Unrelated donor marrow transplantation for XXXX .

@entity1 :: ('9606', 'Species') :: ['patients'] @entity2132 :: ('MESH:D006086', 'Disease') :: ['GvHD', 'graft-versus-host disease'] @entity1860 :: ('MESH:D015464', 'Disease') :: ['CML', 'chronic myelogenous leukaemia'] @entity1533 :: ('3123', 'Gene') :: ['HLA DRB1', 'DRB1', 'HLA-DRB1']
@entity1860 :: (MESH:D015464,Disease) :: ['chronic myelogenous leukaemia']
