GRANULOCYTE-MACROPHAGE COLONY STIMULATING FACTOR (Rhu-GM-CSF) FOR REDUCTION OF LEUKEMIC RELAPSE AFTER T-LYMPHOCYTE DEPLETED ALLOGENEIC BMT FOR CHRONIC MYELOID LEUKEMIA

Date de début de l'étude : 1 février 1995

DISEASE CHARACTERISTICS: Diagnosis of chronic myelogenous leukemia (CML) documented by cytogenetic and molecular analyses at Johns Hopkins Philadelphia chromosome (Ph)-positive or -negative CML Ph-negative CML allowed with presence of either: BCR-ABL rearrangement (on molecular, fluorescent in situ hybridization, or polymerase chain reaction analyses) p210 protein One of the following: Patient age 18 to 65 Disease duration longer than 3 years Accelerated phase CML Accelerated phase diagnosis based on any of the following: More than 10% to less than 30% blasts in blood or bone marrow No hematologic response to prior conventional therapy (hydroxyurea or interferon) Extramedullary disease (e.g., progressive splenomegaly or lymphadenopathy) Basophilia greater than 10% in blood or bone marrow Other cytogenetic abnormalities in addition to a single Ph chromosome Second chronic phase Failure on interferon suggested of patients over age 18 with chronic phase CML, with failure defined as: No detectable Ph-negative metaphases in marrow after 6 months No progressive increase in Ph-negative metaphases in marrow after 6-12 months Less than 50% Ph-negative metaphases after 1 year No complete cytogenetic remission after 2 years Intolerance to interferon therapy No blast crisis CML, chronic myelomonocytic leukemia, or juvenile CML The following conditions are allowed: Leukocyte count abnormalities Fibrosis Anemia Fever or bone pain Thrombocytopenia Bone marrow reticulin Availability of an HLA-identical sibling donor At least 3 years of age (priority given to donors over age 10) Priority given to CMV-negative donor if patient CMV-negative No medical or psychiatric condition that precludes transplant procedure PATIENT CHARACTERISTICS: Age 18 to 65 Performance status ECOG 0-1 Life expectancy Not specified Hematopoietic See Disease Characteristics Hepatic Not specified Renal Not specified Other No history of intolerance to sargramostim (GM-CSF) PRIOR CONCURRENT THERAPY: Biologic therapy See Disease Characteristics Chemotherapy See Disease Characteristics Endocrine therapy Not specified Radiotherapy Not specified Surgery Not specified