Cytogenetic studies on recipients of allogeneic bone marrow transplants after fractionated total body irradiation

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Abstract
Cytogenetic findings from the bone marrow (BM) and the peripheral blood (PB) of 9 consecutive patients after allogeneic bone marrow transplantation (BMT) for acute or chronic myelogenous leukemia are reported. After a conditioning regimen consisting of cyclophosphamide and fractionated total body irradiation (TBI) given in 5 or 6 fractions of 2 Gy [gray], persistence of host cells was detected in 4 out of 7 cases with permanent engraftment. While 1 of these patients relapsed 4 mo. after host cells had been found in BM and PB, the other patients stayed relapse-free 124, 257 and 347 day after grafting. Before transplantation, the leukemic cells in all 3 cases carried unique cytogenetic abnormalities giving the opportunity to distinguish the leukemic population from chromosomally nonaberrant cells thought to represent residual normal host cells. As the persisting host cells after BMT lacked any cytogenetic abnormalities, it is suggested that they were members of residual normal clones not involved in the leukemic process.